Safety and feasibility of deep sedation and general anaesthesia for cardiovascular magnetic resonance imaging studies in paediatric patients from 2 large tertiary European centres

Abstract Purpose To investigate the safety and feasibility of deep sedation(DS) and general anaesthesia(GA) for cardiovascular magnetic resonance(CMR) imaging in paediatric patients with congenital or acquired cardiac diseases. Methods This retrospective study of all consecutive patients less than 18 years of age who had DS for CMR examination at the University Hospital Schleswig-Holstein (Kiel,Germany) between 2010 and 2020 and CMR examination under GA at the Royal Brompton Hospital (London,UK) between 2013 and 2022. Data were collected using CMR reports, anaesthetic charts and medical records. Results Five-hundred twenty-two patients were in DS group and 171 in GA group. Most of the patients had congenital heart disease (86% in DS and 70% in GA group). There were overall 14 adverse events (2%); 8 (1.5%) in the DS group and 6 (3.5%) in GA group. This difference was not statistically significant (p = 0.122). Complications in the DS group included mild anaphylactic reactions in 3 patients, a severe coughing fit in 1 patient, increasing cyanosis in 3 single ventricle patients and suspected aspiration in 1 patient. In the GA group, hypotension requiring some intervention was present in 3 patients(4 scans). One patient(0.6%) had inadvertent endobronchial intubation. One patient with unrepaired double outlet right ventricle and multilevel pulmonary stenosis experienced a severe cyanotic spell on induction to anaesthesia and the scan had to be abandoned. Conclusion Both DS and GA can be used for CMR scans in paediatric patients with a low rate of complications. This however requires highly skilled teams who adhere strongly to the safety policies and guidelines set up by each hospital.