Basics pp 161-172 | Cite as

Perioperative Care in Pediatric Cardiac Surgery

  • Joseé Lavoie
Part of the Anaesthesia, Intensive Care and Pain in Neonates and Children book series (AICPNC)


Congenital heart disease (CHD) is the commonest form of congenital disease with an incidence of 11.6 per 1,000 live births [1]. The perioperative care of children with CHD undergoing cardiac surgery requires an integrated multidisciplinary team approach. The great strides achieved in the care of these children would not have been possible without dedicated teams of medical personnel working with a concerted and standardized approach. The achievements have been such that perioperative mortality rates have decreased significantly. In fact, overall perioperative mortality is currently on average 3.6% [2], with straightforward atrial septal defect (ASD) repair at close to 0% [3] and stage 1 palliation for hypoplastic left heart syndrome at 29% [4]. Expected lifetimes without treatment are 19.5 years for acyanotics and 1.4 years for cyanotics compared to 64.9 years and 46 years, respectively, in treated patients. Although efforts towards reduction of perioperative mortality are continuing, there has been increasing interest in improving perioperative morbidity. Perioperative morbidity may involve the hematological, respiratory, cardiac and nervous systems. In a oneyear survival and neurological outcome study (single-center), the overall survival rate was 92% and the incidence of acute neurological events was 17% in survivors [5]. The risk factors were the presence of elevated red blood cell count, low Apgar score and abnormal preoperative brain imaging.


Congenital Heart Disease Atrial Septal Defect Tranexamic Acid Hypoplastic Left Heart Syndrome Ventricular Assist Device 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Joseé Lavoie
    • 1
  1. 1.“McGill” University, Pediatric Cardiac Anesthesia, Montreal Children’s Hospital “McGill” University Health CenterMontrealCanada

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