Adult Congenital Heart Disease (CHD)
Anesthetic Considerations
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Long term consequences of CHD:
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Cardiac: pulmonary hypertension, heart failure, arrhythmias, residual shunts, valvular lesions
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Non-cardiac: erythrocytosis, cholelithiasis/nephrolithiasis, developmental abnormalities, seizure disorder, CVA, chronic lung disease
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Endocarditis prophylaxis
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Management of medications, especially anticoagulants
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Lesion-specific anesthetic goals & management
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↑ perioperative risk requiring multidisciplinary care
Goals & Conflicts
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Preoperative assessment of cardiac & non-cardiac complications
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Considerations of surgical stress & positioning
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Lesion-specific hemodynamic goals with focus on PVR, SVR, preload, contractility, HR
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Need for invasive monitoring including arterial line & central line placement
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De-airing of lines