Pre-anesthetic echocardiographic findings in children undergoing non-cardiac surgery at the University of Benin Teaching Hospital, Nigeria

Abstract

SummaryBackgroundA pre-anaesthestic echocardiogram (echo) is requested for most non-cardiac surgeries to identify possible cardiac structural anomaliesObjectiveTo describe the prevalence and spectrum of structural cardiac abnormalities seen in various non-cardiac conditionsMethodsWe carried out a retrospective review of pre-anaesthetic echos performed over five years on children scheduled for non-cardiac surgery. The requests were categorised according to referring specialities, and the biodata and echo findings were notedResultsA total of 181 children and 181 echocardiograms were studied, and 100 (55.2%) of the patients were male. Most of the children (87, 48.1%) with oro-facial clefts were referred from dentistry. Of the 181 children, 39 (21.5%) had cardiac abnormalities, most (34, 87.2%) of whom had congenital heart disease (CHD). Ophthalmic requests with suspected congenital rubella syndrome (CRS) had the highest prevalence of 8/12 (66.7%) while the lowest was oro-facial clefts at 15/87 (17.2%). Atrial septal defect was the commonest abnormality, found in 14 patients (35.9%)ConclusionPre-anaesthetic echo should be performed, especially for children with suspected CRS and other congenital anomalies, requiring non-cardiac surgery.

Genomics and Epigenomics of Congenital Heart Defects: Expert Review and Lessons Learned in Africa

“…A few decades ago, CHD diagnoses were not common in Africa. With improvements in health service delivery and healthcare professional training (Budzee et al, 2010), CHD diagnosis and treatment at an early age is allowing for children with CHD to live (Ejim et al, 2013;Methlouthi et al, 2016;Nkoke et al, 2017;Sadoh et al, 2016;Sani et al, 2007).…”

Spectrum of associated congenital heart defects in patients with “Non-Cardiac Congenital defects at a tertiary care children hospital in Pakistan”

“…1 This often necessitates a request for cardiovascular evaluation, including echocardiography (echo) as part of the preanesthesia evaluation to reduce anesthesia risk. 2 Patients undergoing non-cardiac surgery may have conditions commonly associated with congenital heart diseases (CHD), such as children with cleft lip and palate, diaphragmatic hernia, omphalocele, tracheoesophageal fistula, skeletal anomalies, anorectal malformations and congenital vascular malformations. 3 The presence of congenital anomalies in one system may be associated with increased incidence of congenital anomalies in other systems.…”

“…4 It is imperative that children with such suspected cardiac anomalies or those with conditions commonly associated with CHD undergoing non-cardiac surgery should be evaluated for the presence of cardiovascular anomaly. 2 From the studies in developing countries, the prevalence of CHD in children with cleft lip and palate ranges from 9-20%. 5,6 The prevalence is higher in those with cleft palate than in those with cleft lip only.…”

“…This relatively high prevalence of CHD in children with oro-facial cleft has prompted the policy in most centers of pre-anaesthetic echo for all such patients. 2 Congenital heart defects (CHD) are considered to be the most important form of congenital defects causing high rates of morbidity and mortality among children. 7 CHD is defined as the structural or functional heart defect which is present at the time of birth even if detection is made later on.…”

“… 1 This often necessitates a request for cardiovascular evaluation, including echocardiography (echo) as part of the pre-anesthesia evaluation to reduce anesthesia risk. 2 …”