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Erschienen in: Current Cardiology Reports 3/2022

26.01.2022 | Congenital Heart Disease (RA Krasuski and G Fleming, Section Editors)

Anesthetic Management in Adults with Congenital Heart Disease

verfasst von: Jon S. Andrews, Nazish K. Hashmi

Erschienen in: Current Cardiology Reports | Ausgabe 3/2022

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Abstract

Purpose of Review

Adults with congenital heart disease (ACHD) are a complex and growing population that presents numerous challenges for anesthetic management. This review summarizes special considerations for anesthetic management in ACHD.

Recent Findings

The adult patient with congenital heart disease may require anesthetic care for multiple surgeries and interventions throughout their lifetime. The cardiac and extracardiac manifestations of ACHD have important perioperative implications that affect anesthetic management. Recent American Heart Association/American College of Cardiology and European Society of Cardiology guidelines endorse a multidisciplinary, team-based approach to care. The cardiac anesthesiologist, endorsed as part of this multidisciplinary team, must have a thorough understanding of congenital heart disease pathophysiology and common extra-cardiac manifestations of ACHD.

Summary

Safe anesthetic management in adult congenital heart disease should incorporate a multi-disciplinary approach to patient care. Anesthesiologists and centers with special expertise in ACHD care should be utilized or consulted whenever possible.
Literatur
9.
Zurück zum Zitat •• Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Circulation 2019;139(14):e698–e800. https://doi.org/10.1161/CIR.0000000000000603. Updated guideline which includes specific recommendations for specialized ACHD centers, including utilization of anesthesiologists with ACHD expertise. •• Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Circulation 2019;139(14):e698–e800. https://​doi.​org/​10.​1161/​CIR.​0000000000000603​. Updated guideline which includes specific recommendations for specialized ACHD centers, including utilization of anesthesiologists with ACHD expertise.
15.
20.
Zurück zum Zitat Fishberger SB, Wernovsky G, Gentles TL, Gauvreau K, Burnett J, Mayer JE Jr, et al. Factors that influence the development of atrial flutter after the Fontan operation. J Thorac Cardiovasc Surg. 1997;113(1):80–6.CrossRefPubMed Fishberger SB, Wernovsky G, Gentles TL, Gauvreau K, Burnett J, Mayer JE Jr, et al. Factors that influence the development of atrial flutter after the Fontan operation. J Thorac Cardiovasc Surg. 1997;113(1):80–6.CrossRefPubMed
22.
Zurück zum Zitat Ghai A, Harris L, Harrison DA, Webb GD, Siu SC. Outcomes of late atrial tachyarrhythmias in adults after the Fontan operation. J Am Coll Cardiol. 2001;37(2):585–92.CrossRefPubMed Ghai A, Harris L, Harrison DA, Webb GD, Siu SC. Outcomes of late atrial tachyarrhythmias in adults after the Fontan operation. J Am Coll Cardiol. 2001;37(2):585–92.CrossRefPubMed
35.
Zurück zum Zitat Desborough MJ, Oakland KA, Landoni G, Crivellari M, Doree C, Estcourt LJ, et al. Desmopressin for treatment of platelet dysfunction and reversal of antiplatelet agents: a systematic review and meta-analysis of randomized controlled trials. J Thromb Haemost. 2017;15(2):263–72. https://doi.org/10.1111/jth.13576.CrossRefPubMed Desborough MJ, Oakland KA, Landoni G, Crivellari M, Doree C, Estcourt LJ, et al. Desmopressin for treatment of platelet dysfunction and reversal of antiplatelet agents: a systematic review and meta-analysis of randomized controlled trials. J Thromb Haemost. 2017;15(2):263–72. https://​doi.​org/​10.​1111/​jth.​13576.CrossRefPubMed
61.
Zurück zum Zitat • Bianchi P, Constantine A, Costola G, Mele S, Shore D, Dimopoulos K, et al. Ultra-fast-track extubation in adult congenital heart surgery. J Am Heart Assoc. 2021;10(11):e020201. https://doi.org/10.1161/JAHA.120.020201. This retrospective study in a large population of patients found that ultra-fast-track extubation in the operating room was associated with a low reintubation rate, decreased use of vasopressors, and more rapid discharge from ICU. • Bianchi P, Constantine A, Costola G, Mele S, Shore D, Dimopoulos K, et al. Ultra-fast-track extubation in adult congenital heart surgery. J Am Heart Assoc. 2021;10(11):e020201. https://​doi.​org/​10.​1161/​JAHA.​120.​020201. This retrospective study in a large population of patients found that ultra-fast-track extubation in the operating room was associated with a low reintubation rate, decreased use of vasopressors, and more rapid discharge from ICU.
65.
Zurück zum Zitat Maxwell BG, Posner KL, Wong JK, Oakes DA, Kelly NE, Domino KB, et al. Factors contributing to adverse perioperative events in adults with congenital heart disease: a structured analysis of cases from the Closed Claims Project. Congenit Heart Dis. 2015;10(1):21–9. https://doi.org/10.1111/chd.12188.CrossRefPubMed Maxwell BG, Posner KL, Wong JK, Oakes DA, Kelly NE, Domino KB, et al. Factors contributing to adverse perioperative events in adults with congenital heart disease: a structured analysis of cases from the Closed Claims Project. Congenit Heart Dis. 2015;10(1):21–9. https://​doi.​org/​10.​1111/​chd.​12188.CrossRefPubMed
Metadaten
Titel
Anesthetic Management in Adults with Congenital Heart Disease
verfasst von
Jon S. Andrews
Nazish K. Hashmi
Publikationsdatum
26.01.2022
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 3/2022
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-022-01639-y

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