{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T16:19:45Z","timestamp":1764260385246,"version":"3.41.2"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":351,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Cardiology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Ebstein\u2019s anomaly is a rare congenital displacement of the tricuspid valve resulting in atrialization of the right ventricle. About half of the patients with Ebstein\u2019s anomaly also have atrial septal defects, which may lead to chronic shunting and development of Eisenmenger syndrome. We describe a case of a sexagenarian male patient with a history of Ebstein\u2019s anomaly complicated with Eisenmenger syndrome undergoing robotic laparoscopic adrenalectomy who presented hemodynamic instability, hypoxemia, and likely right\u2010to\u2010left shunting intraoperatively, as well as the actions taken to correct it and have a successful outcome. Perioperative management of adult patients with congenital heart defects is complex and requires careful monitoring. When available, intraoperative transesophageal echocardiography is strongly recommended. To prevent right\u2010to\u2010left shunting, maintaining elevated systemic vascular resistance with the use of vasopressors and low positive end\u2010expiratory pressure (PEEP) ventilation is critical.<\/jats:p>","DOI":"10.1155\/cric\/8283566","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T15:04:58Z","timestamp":1734447898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraoperative Hemodynamic Instability in a Patient With Ebstein\u2019s Anomaly Complicated With Eisenmenger Syndrome"],"prefix":"10.1155","volume":"2024","author":[{"given":"Leonardo A.","family":"Marquez Roa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Araujo-Duran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Hofstra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6653-0661","authenticated-orcid":false,"given":"Jibran","family":"Ikram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6728-9297","authenticated-orcid":false,"given":"Sabry","family":"Ayad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2023.01.016"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1089253215605390"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000603"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-316665"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2013.11.022"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2005.12.016"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1184-7"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181ae51a6"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1213\/XAA.0000000000000387"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.4081\/cp.2017.969"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000430"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/763181"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-74766-8_3"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200310000-00036"}],"container-title":["Case Reports in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/8283566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T15:05:01Z","timestamp":1734447901000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cric\/8283566"}},"subtitle":[],"editor":[{"given":"Yigit","family":"Canga","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1155\/cric\/8283566"],"URL":"https:\/\/doi.org\/10.1155\/cric\/8283566","archive":["Portico"],"relation":{},"ISSN":["2090-6404","2090-6412"],"issn-type":[{"type":"print","value":"2090-6404"},{"type":"electronic","value":"2090-6412"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2024-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8283566"}}