The Pediatric Cardiac Anesthesia Handbook

Preface to the Second Edition xix

Part I The Basics 1

1 Cardiovascular Development 3

2 Important Concepts in Congenital Heart Disease 9

3 Preoperative Evaluation 23

4 Intraoperative Management 33

5 Developmental Hemostasis and Patient Blood Management 41

6 Interpretation of Cardiac Catheterization Data 49

7 Management of Cardiopulmonary Bypass 63

8 Echocardiography 85

9 Risk Scoring Systems in Patients with Congenital Heart Disease 103

10 Mechanical Circulatory Support 109

11 Postoperative Cardiac Intensive Care Unit Care 127

Part II Specific Lesions 143

12 Patent Ductus Arteriosus 145

13 Aortopulmonary Window 149

14 Coarctation of the Aorta 153

15 Atrial Septal Defect 161

16 Ventricular Septal Defect 167

17 Atrioventricular Canal Defects 171

18 Double Outlet Right Ventricle 177

19 Truncus Arteriosus 183

20 Total Anomalous Pulmonary Venous Return 187

21 Left Ventricular Outflow Tract Obstruction 193

22 Mitral Valve 199 Mitral Valve Stenosis 199

23 Pulmonary Atresia/Intact Ventricular Septum 207

24 Tetralogy of Fallot 213

25 Tetralogy of Fallot with Pulmonary Atresia 225

26 Tetralogy of Fallot with Absent Pulmonary Valve 229

27 Transposition of the Great Arteries 233

28 Single-ventricle Lesions 247

29 Hypoplastic Left Heart Syndrome 269

30 Interrupted Aortic Arch 275

31 Vascular Rings 281

32 Tricuspid Atresia 285

33 Heart Transplantation 289

34 Heart-Lung and Lung Transplantation 307

35 Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery and Anomalous Aortic Origin of a Coronary Artery 321

36 Heterotaxy 327 Introduction 327

37 Ebstein Anomaly 333

Index 339

A concise yet comprehensive overview of the anesthetic management of pediatric patients with congenital heart disease

Designed for ease of use, The Pediatric Cardiac Anesthesia Handbook is divided into two parts: Part One covers the basic assessment of patients, including cardiovascular physiology, the pathophysiology of coronary heart disease, preoperative evaluation, intraoperative management, and interpretation of cardiac catheterization data. Part Two contains templated chapters that address a variety of disorders, allowing easy reference to anatomical and physiological features, surgical therapies, anesthetic approach, and postoperative management.

Now in its second edition, The Pediatric Cardiac Anesthesia Handbook contains new chapters on coagulation and blood management, echocardiography, risk scoring systems, and postoperative critical care management, as well as a completely revised chapter on mechanical circulatory support.

Providing clear and reliable, this easily referable pocket-sized resource:

• Addresses the additional complexities of pediatric patients and the anesthetic considerations for non-cardiac surgery after heart and heart-lung transplantation
• Provides guidelines on specific lesions for the pediatric anesthesiologist caring for cardiac patients presenting for non-cardiac surgery
• Contains templated chapters that allow easy reference by members of the multidisciplinary team, such as cardiologists, cardiac intensivists, perfusionists, and surgeons
• Features high-quality illustrative echocardiographic images in every chapter and bulleted content designed for rapid reference

Written by an expert author team at the world-renowned Boston Children’s Hospital, The Pediatric Cardiac Anesthesia Handbook is a must-have guide and study aid for anesthesiology and cardiac critical care trainees and practitioners who manage patients with congenital heart disease.

VIVIANE G. NASR, M.D., MPH, FASA is Chief of the Division of Cardiac Anesthesia at Boston Children’s Hospital, where he holds the Francis X. McGowan, Jr., MD Chair in Cardiac Anesthesia. Dr. Nasr is an Associate Professor of Anesthesia at Harvard Medical School.

JAMES A. DINARDO, M.D., FAAP, FASA is the past Chief of the Division of Cardiac Anesthesia at Boston Children’s Hospital and previous holder of the Francis X. McGowan, Jr., MD Chair in Cardiac Anesthesia. Dr. DiNardo is a Professor of Anesthesia at Harvard Medical School.