Step 1 of 9
Classification
A good understanding of haemodynamic impairments caused by congenital heart diseases is required to ensure appropriate management of children’s anaesthesia and treatment. It helps to choose the most suitable anaesthetic technique in each individual case. Before specifically addressing each disease, it will therefore be useful to mention strategies that should be considered, based on the classification of congenital heart diseases mentioned in the previous section:
- Non-cyanotic heart diseases with L-to-R shunt and increased pulmonary blood flow;
- Non-cyanotic heart diseases without shunting;
- Cyanotic heart diseases with R-to-L shunt and reduced pulmonary blood flow;
- Cyanotic heart diseases with R-to-L shunt and reduced aortic blood flow;
- Cyanotic heart diseases with a bidirectional shunt.
© BETTEX D, BOEGLI Y, CHASSOT PG, June 2008, last update May 2018
14. Anesthesia for paediatric heart surgery
- 14.1 Introduction
- 14.2 Pathophysiology
- 14.3 Haemodynamic strategies
- 14.3.1 Classification
- 14.3.2 Left-to-right shunt and high pulmonary blood flow
- 14.3.3 Pulmonary hypertension in children
- 14.3.4 Cyanotic right → left shunt and reduced pulmonary blood flow
- 14.3.5 Cyanotic right → left shunt and reduced systemic blood flow
- 14.3.6 Bidirectional cyanotic shunt
- 14.3.7 Heart diseases without shunting: obstructions and valvular heart diseases
- 14.3.8 Treatment options for neonates
- 14.3.9 Drug therapy
- 14.4 Anaesthetic technique
- 14.5 CPB in children
- 14.6 Anaesthesia for specific pathologies
- 14.6.1 Introduction
- 14.6.2 Anatomical landmarks
- 14.6.3 Anomalous venous returns
- 14.6.4 Atrial septal defects (ASDs)
- 14.6.5 Atrioventricular canal (AVC) defects
- 14.6.6 Ebstein anomaly
- 14.6.7 Anomalies of the atrioventricular valves
- 14.6.8 Ventricular septal defects (VSDs)
- 14.6.9 Ventricular hypoplasia
- 14.6.10 Tetralogy of Fallot
- 14.6.11 Double outlet right ventricle (DORV)
- 14.6.12 Pulmonary atresia
- 14.6.13 Anomalies of the left ventricular outflow
- 14.6.14 Transposition of the great arteries (TGA)
- 14.6.15 Truncus arteriosus
- 14.6.16 Coarctation of the aorta
- 14.6.17 Arterial abnormalities
- 14.6.18 Heart transplantation
- 14.7 Conclusions