Caso clínico: Trasplante cardiaco tras una cirugía de fontan, toda una lucha

Resumo

Single-ventricle heart is a complex entity that encompasses those congenital cardiopathies wherein there are not two functional ventricles to propel blood separately to the pulmonary-systemic circulations, which run in parallel. Its correction involves palliative surgeries, such as the Fontan procedure, or heart transplantation, as a treatment thereof. We present the case of a 42-year-old woman, who was admitted into the cardiac post-operative intensive care unit after an orthotopic heart transplantation as treatment for her complex congenital cardiopathy. During her hospitalization, she had respiratory complications, worsening of her renal dysfunction and a considerable anxiety. We created an individualized care plan in accordance with the 14-need assessment of Virginia Henderson’s model, emphasizing the nursing diagnoses: deterioration of gas exchange, risk of electrolytic imbalance and fear. We managed to improve her ventilatory function, to stabilize her renal function and to reduce her anxiety, and she stayed 10 days at the unit until discharge. The nursing team work was of key importance to help the patient face all the fears she manifested.