www.SCAI.org/Guidelines
Table 1. Anesthetic Risks for Specific Patients and Procedures
High-risk patients and procedures
for anesthesia
Possible adverse events from
anesthesia
Williams-Beuren Syndrome Hypotension, coronary ischemia, cardiac
arrest
Hypertrophic Cardiomyopathy Coronary ischemia, cardiac arrest
Single-Ventricle Physiolog y Coronary ischemia, cardiac arrest
Aortic Valve Stenosis Low cardiac output (CO), coronary
ischemia, cardiac arrest
Mitral Valve Stenosis Low CO, right ventricular (RV) failure
Pulmonary Hypertension RV failure, pulmonary hypertensive
crisis, cardiac arrest
Pulmonary Vein Dilation RV failure, pulmonary edema, hypoxia
VSD Device Closure Arrhythmia, low CO, cardiac arrest
Balloon Atrial Septostomy (newborns
with single-ventricle physiolog y and le
atrio-ventricular [AV] valve hypoplasia
or atresia)
Hypoxia, atrial perforation, cardiac
tamponade
s/p Heart Transplant Ventricular fibrillation (VF), myocardial
ischemia
Diagnosis
Treatment
Î There is no specific anesthetic method that is appropriate for all
patients with CHD in the pediatric congenital cardiac catheterization
laboratory (PCCCL).
Î There is no preferred ventilation strategy in the cardiac catheterization
laboratory.
Î Attention to detail regarding the intravascular volume and hematocrit
in patients with congenital heart disease is imperative during cardiac
catheterizations, and physiologic alterations should be promptly
addressed.
