Critical Care Management of the Adult Patient with Congenital Heart Disease: Focus on Postoperative Management and Outcomes

Abstract

Advances in surgical techniques and in the medical management of children with congenital heart disease has increased survival into adulthood, resulting in a population of adults with congenital heart disease now surpassing the pediatric population in numbers. Furthermore, many of the patients will require repeat surgical, catheter-based, procedures and/or obstetrical care in their adult lives, and understanding the specific cardiopulmonary physiology and the involvement of other organ systems is critical to successful intervention. A team approach, with consultants from medical specialties in the setting of an established adult congenital heart center, is the optimal setting for superior outcomes. In this review, we discuss critical care management of the adult congenital heart disease patient in the perioperative period.

Congenital Heart Disease in the Adult Presenting for Noncardiac Surgery

“…Glucose control can significantly improve morbidity and mortality in adult patients undergoing cardiac surgery for acquired disease, but controversy persists whether these findings can be extrapolated to ACHD patients and, if so, exactly how tight the glucose control should be. 15 Regional anesthesia has also been safely performed in certain ACHD patients with special attention being paid to coagulation status and the use of commonly prescribed anticoagulant medications.…”