Anaesthesia in chidlren with congential heart disease for non-cardiac surgery

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Originally from https://resources.wfsahq.org/uia/vol-37-paediatrics-special-edition/ | Update in Anaesthesia

Divya Raviraj* and Michelle. C. White

*Correspondence email: divya.raviraj@nhs.net

doi:10.1029/WFSA-D-20-00004

Divya Raviraj MB CHB, FRCA Specialist Registrar  in Anaesthesia Great Ormond Street Hospital London UK

Michelle. C. White, MB CHB, DCH, FRCA Consultant in Paediatric Cardiac Anaesthesia Great Ormond Street Hospital London UK

Abstract

There is an increasing prevalence of children with congenital heart disease (CHD) presenting for non cardiac surgery due to advances in modern medicine which means more children with CHD are surviving for longer and are thus exposed to the usual illnesses and injuries of childhood.  The complex nature of some cardiac lesions, and the frequent association of CHD with other congenital abnormalities means that the perioperative care of these children presents unique challenges for the anaesthetist. This article aims to review the perioperative considerations of children with CHD presenting for non-cardiac surgery. We provide a classification of CHD based on physiology, identify important factors for consideration during risk stratification and discuss an evidence-based approach to perioperative management.