Cardiac for Non-Cardiac Surgery Guidelines

Guidelines regarding Anesthesia for Children with Congenital Heart Disease undergoing Non-cardiac Surgery

Children with congenital heart disease undergoing non-cardiac surgery/procedures are at increased risk for perioperative morbidity and mortality.

To align the appropriate resources (both personnel, location, ECMO & CV surgical availability, and equipment) for children with complex physiology, the surgeon/proceduralist should consult with a pediatric cardiac anesthesiologist in advance of the scheduled procedure for the following patients:

· Patients with ductal or aortopulmonary shunt dependent lesions

• • s/p Norwood with Sano or BT shunt (pre-Glenn)

  • Infants requiring prostins

  • Infants with PDA stents

· Patients currently in the CVICU

· Patients with moderate to severe ventricular dysfunction

· Patients with severe pulmonary hypertension secondary to congenital heart disease

· Patients with moderate to severe aortic or mitral stenosis

· Patients with William’s Syndrome or non-syndromic supravalvar aortic stenosis

· Patients with single ventricle physiology prior to Glenn and Fontan

· Patients with Glenn or Fontan physiology with moderate to severe AV valve regurgitation or moderate to severe ventricular dysfunction