Key result
There is no evidence that one method of anesthesia is superior to another for noncardiac surgery in patients with adult congenital heart disease, highlighting the need for tailor-made management.
Why the study?
More patients with congenital heart disease are reaching adulthood and undergoing noncardiac surgery, but no single anesthetic method is proven superior.
Tailor-made anesthetic management based on thorough preoperative evaluation of hemodynamics and surgical risk is crucial for ACHD patients undergoing noncardiac surgery.
May guide individualized anesthesia in ACHD noncardiac surgery; leaves open need for RCTs to identify optimal techniques.
先天性心疾患患者の多くが成人期を迎える時代となり，成人先天性心疾患（ACHD：adult congenital heart disease）の患者が非心臓手術を受ける機会が増加している．ACHDは全身性の疾患であり，非心臓手術の麻酔では術前評価が極めて重要である．ACHD患者の非心臓手術の麻酔管理には，一つの麻酔方法が他の方法に優るというエビデンスはなく，個々の症例において血行動態を把握し，手術のリスクを評価して，生じ得る合併症を予測したテイラーメイドの麻酔管理が重要となる．
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Katsunori Oe (2023) conducted a review in Adult congenital heart disease (ACHD) undergoing noncardiac surgery. Anesthetic management was evaluated. There is no evidence that one method of anesthesia is superior to another for noncardiac surgery in patients with adult congenital heart disease, highlighting the need for tailor-made management.
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