Knowledge and Attitudes of Anesthesia Providers about Noncardiac Surgery in Adults with Congenital Heart Disease

Maxwell, Bryan G.; Williams, Glynn D.; Ramamoorthy, Chandra

doi:10.1111/chd.12076

Cited by 20 publications

(9 citation statements)

References 8 publications

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“…In the United States, general anesthesia knowledge and training standards for ACHD are lacking, resulting in a low level of knowledge and comfort with providing perioperative and obstetric care for patients with ACHD, even in academic centers. 26 Cardiac and noncardiac surgical procedures in patients with CHD carry an increased risk for perioperative adverse events. Factors judged to have a major contribution to adverse events were the nature of CHD (50%), preoperative assessment or optimization (40%), intraoperative anesthetic care (55%), and postoperative monitoring/care (50%).…”

Section: Perioperative Care For Adult Patients With Congenital Heart mentioning

confidence: 99%

Heart Failure in Adult Patients with Congenital Heart Disease

Smit-Fun

Buhre

2019

Anesthesiology Clinics

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Owing to advances in cardiac surgery, intensive care, and diagnostic capabilities, 88% of children born with a congenital heart disease (CHD) survive into adulthood. 1-3 Besides arrhythmias, (end-stage) heart failure is the primary source of morbidity and mortality. In accordance with the increasing number of adult patients with CHD (ACHD) a , the need for noncardiac surgical and interventional procedures is increasing, both in the elective and acute settings. Therefore, there is a practical need for anesthesiologists to be familiar with the pathophysiologic considerations. In this review, Disclosure Statement: None.

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Section: Perioperative Care For Adult Patients With Congenital Heart mentioning

confidence: 99%

Heart Failure in Adult Patients with Congenital Heart Disease

Smit-Fun

Buhre

2019

Anesthesiology Clinics

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“…In one study, 55% of adverse events or death were related to intraoperative anesthetic care [ 58 ]. While repaired simple ACHD patients can be managed by most anesthesia providers, there are significant knowledge gaps when approaching complex ACHD [ 60 ].…”

Section: Anesthesiamentioning

confidence: 99%

Building an Adult Congenital Heart Program: Critical Components and Important Allies

et al. 2018

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Purpose of the ReviewThe purpose of this review is to illustrate specific challenges and opportunities in the building of an adult congenital heart disease (ACHD) program and to highlight critical components and important allies.Recent FindingsWith more than 1.4 million adults with congenital heart disease in the USA alone, access to specialized, compassionate, high-quality comprehensive care requires a shift toward more aggressive expansion of ACHD care, especially in the context of sparse ACHD provider representation in the vast majority of adult medical centers.SummaryThe effective build of an ACHD program requires measured escalation in management of ACHD complexity matched with cultivation of key resources and clinical services ranging from congenital cardiac surgery and interventional cardiology to acquired heart disease as well as partnerships with non-cardiac specialists. By reframing ACHD care as a shared goal between patients, providers, hospitals, pharmaceutical and device industry, and payers, a potent business model can be built around the developing ACHD program to facilitate acquisition of these key resources.

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“…In an institutional survey, Maxwell et al 22 evaluated the knowledge of anesthesia providers with respect to ACHD. Although the total knowledge scores differed significantly Figure 2.…”

Section: Type Of Anesthesiologistmentioning

confidence: 99%

Advances in the Care of Adults With Congenital Heart Disease

Nasr

Kussman

2014

Semin Cardiothorac Vasc Anesth

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The significant decline in mortality among children and adolescents with congenital heart disease (CHD) is associated with an increasing prevalence of CHD in adults, particularly those with moderate to severe defects. As a significant percentage of adolescents and young adults are lost to follow-up in the transition from pediatric to adult care, they may present for elective procedures with substantial CHD-associated morbidity. In addition to the specific cardiac defect, the procedures performed, and the current pathophysiological status, several factors should be considered when managing the adult with CHD. These include the type of setting (adult vs pediatric institution); surgeon (pediatric vs adult cardiac surgeon); coexisting diseases associated with CHD, such as coronary artery disease, hepatic dysfunction, renal dysfunction, cerebrovascular accidents, myopathy, and coagulation disorders; acquired diseases of aging; pregnancy; and psychosocial functioning. The current status of the management of common and important congenital cardiac defects is also described.

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Knowledge and Attitudes of Anesthesia Providers about Noncardiac Surgery in Adults with Congenital Heart Disease

Abstract: Within the context of the limitations of a single-institution survey design, the low levels of knowledge and comfort we observed suggest that providers may benefit from improved training and protocols for ensuring adequate preparedness for the care of ACHD patients.

Cited by 20 publications

References 8 publications

Heart Failure in Adult Patients with Congenital Heart Disease

Heart Failure in Adult Patients with Congenital Heart Disease

Building an Adult Congenital Heart Program: Critical Components and Important Allies

Advances in the Care of Adults With Congenital Heart Disease

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