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The patient with congenital heart disease in ambulatory surgery

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ELSEVIER
DOI: 10.1016/j.bpa.2022.11.006

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congenital heart disease (CHD); adult congenital heart disease (ACHD); ambulatory surgery; endocarditis; pulmonary hypertension (PH)

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Deciding whether a patient with congenital heart disease (CHD) is suitable for ambulatory surgery is challenging due to various factors such as the type of procedure, complexity of pathology, patient classification, comorbidities, and medication. Previous studies reported higher perioperative mortality and morbidity rates in CHD patients, but most of them were conducted on hospitalized patients and may not apply to ambulatory settings.
The number of patients with congenital heart disease (CHD) un-dergoing ambulatory surgery is increasing. Deciding whether a CHD patient is suitable for an ambulatory procedure is still chal-lenging. Several factors must be considered, including the type of planned procedure, the complexity of the underlying pathology, the American Society of Anesthesiologists' Physical Status classi-fication of the patient, and other patient-specific factors, including comorbidity, chronic complications of CHD, medication, coagula-tion disorders, and issues related to the presence of a pacemaker (PM) or cardioverter-defibrillator.Numerous studies reported higher perioperative mortality and morbidity rates in surgical patients with CHD than non-CHD pa-tients. However, most of these studies were conducted in a cohort of hospitalized patients and may not reflect the ambulatory setting. The current review aims to provide the anesthesiologist with an overview and practical recommendations on selecting and managing a CHD patient scheduled for an ambulatory procedure.(c) 2022 Elsevier Ltd. All rights reserved.

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