Laparoscopic surgery in a paediatric patient with Down's syndrome and patent foramen ovale

The safety of laparoscopic surgery in infants with congenital heart disease has been a subject of controversy despite potential benefits over open surgery. The authors present the anaesthetic management of a 6-month-old female infant with Down's syndrome with a small patent foramen ovale with left to right shunt who successfully underwent laparoscopic coloplasty. There were no intraoperative or postoperative complications. In addition to the routine anaesthetic considerations for any surgical patient, the choice of the anaesthetic technique in patients undergoing laparoscopic procedures should consider the effect on the patient's underlying cardiorespiratory function of pneumoperitoneum and carbon dioxide insufflation.