Familiarity with pathophysiology and careful perioperative planning are essential for safe anesthetic management of children with congenital heart disease undergoing noncardiac surgery.
Underscores need for CHD expertise in noncardiac cases; leaves open prospective validation of specific protocols.
This review covers the classification of congenital heart diseases, and the preoperative assessment, monitoring, anesthetic considerations, and management in the pediatric population with congenital heart disease. It does not present “recipes” for individual cardiac defects. The pathophysiology is presented as it relates to principles of management, patient assessment, selection, and application of an anesthetic regimen to specific cardiac lesions and procedures. Familiarity with the child's pathophysiology, preoperative preparation, choice of monitors, induction, maintenance, emergence from anesthesia, and plans for the postoperative period should avoid major problems in anesthetic management.
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Yumul et al. (2003) studied this question.
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