This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Heggie, J. Articles by Karski, J. Search for Related Content PubMed Articles by Heggie, J. Articles by Karski, J. Social Bookmarking                   What's this?

Anesthetic Considerations for Adult Cardiac Surgery Patients with Congenital Heart Disease

Department of Cardiovascular Anaesthesia, Toronto General Hospital, University Health Network, Ontario, Canada; Department of Anaesthesia, Eaton-North 3-425, Toronto General Hospital, 200 Elizabeth St., Toronto, Ontario M5G 2C4, Canada; jane.heggie{at}uhn.on.ca

Nancy Poirer, MD

Department of Surgery, Montreal Heart Institute, University of Montreal, Quebec, Canada

William G. Williams, MD

Hospital for Sick Children, University of Toronto, Ontario, Canada

Jacek Karski, MD

Cardiovascular Anesthesia, Toronto General Hospital, University Health Network, Ontario, Canada

The number of adults with congenital heart disease surviving into adulthood is increasing. The proportion of adults undergoing revision of a previous repair is increasing in comparison to those that present for a palliative or curative operation. At the Toronto Congenital Cardiac Centre for Adults, 528 patients underwent cardiac surgery between January 1, 1992 and December 31, 2001. The anesthetic management of the surgical correction of simple and complex congenital heart lesions includes general physiologic considerations such as dysrhythmias, hypoxemia, polycythemia, and pulmonary hypertension. Palliative shunts from early childhood have anatomical and physiologic implications for the adult. Preparation for the operating room and postoperative care are natural extensions of the anesthetic management of the surgical correction of the congenital heart lesions. Anesthetic management of septal lesions in the interventional suite and operating room is discussed. Complex lesions such as tetralogy of Fallot, transposition of the great arteries, Glenn anastomosis, and the Fontan operation are reviewed. The anesthetic management of these patients is rewarding but impossible without an integrated team approach involving cardiologists, surgeons, perfusionists, and nursing staff.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?