Patients with adult congenital heart disease presenting for noncardiac surgery.

PURPOSE OF REVIEW: With advances in surgical, medical, and anesthetic management, most patients born with congenital heart disease survive into adulthood. Patients with adult congenital heart disease (ACHD) present in increasing numbers for noncardiac surgery. As this population continues to grow, anesthesiologists in every practice will come into contact with them. Understanding the complex challenges ACHD patients pose is critical to providing safe anesthesia.

RECENT FINDINGS: This literature review brings to light themes of long-term outcomes in CHD, risk and management issues in providing care for ACHD undergoing noncardiac surgery, and the unique issues women with ACHD face during pregnancy, and can be used to assist anesthesiologists in decision making and perioperative planning.

SUMMARY IMPLICATIONS: Adults with CHD who present for noncardiac surgery carry an increased risk for significant morbidity and mortality in the perioperative phase. This paper can help anesthesiologist inform their decisions on who should care for these patients and where that should occur. It also provides guidance on how to provide care. Readers are encouraged to further obtain there required knowledge and skill to care for patients with ACHD.