Key result
General anesthesia for pediatric cardiac MRI was completed without significant incident in 71% of cases, with minor adverse incidents in 32 patients and one major adverse event.
Observational (n=120)
No
General anesthesia for pediatric cardiac MRI in children with congenital heart disease is generally safe but carries a higher complication rate than in the general pediatric population, necessitating a senior multidisciplinary team.
Supports anesthesia feasibility for pediatric cardiac MRI in CHD with experienced teams; leaves open comparative safety trials versus non-cardiac populations.
BACKGROUND/OBJECTIVES: Cardiac MRI (CMR) is increasingly used for surgical planning and serial monitoring of children with congenital heart disease (CHD). For small children, general anesthesia (GA) is required. We describe our experience of the safety of GA for pediatric CMR, using data collected prospectively over 3 years. METHODS: All consecutive infants undergoing GA for CMR at our institution, between November 2005 and May 2008, were included. Informed and written consent to participate in research investigation was acquired from the guardians of every patient prior to CMR. The cardiac anesthetist completed a standardized data collection form during each procedure. Information collected included demographics, diagnosis, surgical history, anesthetic management, significant incidents, and discharge circumstances. RESULTS: A total of 120 patients with varying cardiac physiology and a range of hemodynamics underwent GA for CMR during the study period. Gas induction was predominantly used, even in those with impaired ventricular function. The majority (71%) of procedures were undertaken without significant incident. Minor adverse incidents were recorded in 32 patients, mild hypotension being most frequent. One major adverse event occurred. A patient with hypoplastic left heart syndrome (HLHS) suffered hypotension then cardiac arrest in the scanner. This patient was successfully resuscitated. CONCLUSION: Although the majority of cases were safe and without incident, the complication rate in children with CHD receiving a GA for CMR is higher than in the general pediatric population. This reinforces the need for a senior, multidisciplinary team to be involved in the care of these children during imaging.
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Stockton et al. (2012) conducted an observational in Congenital heart disease (n=120). General anesthesia was evaluated on Procedures without significant incident. General anesthesia for pediatric cardiac MRI was completed without significant incident in 71% of cases, with minor adverse incidents in 32 patients and one major adverse event.
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