Perioperative Care of Children with Eisenmenger Syndrome Undergoing Non-cardiac Surgery

Area of Science:

• Cardiology
• Pulmonary Hypertension
• Congenital Heart Disease

Background:

• Eisenmenger syndrome (ES) is a severe pulmonary arterial hypertension complication of congenital heart disease with shunts.
• ES patients exhibit multisystem involvement due to chronic hypoxemia, leading to significant morbidity and mortality.
• Improved survival in ES necessitates addressing perioperative care for incidental surgeries.

Purpose of the Study:

• To review and provide guidelines for the safe perioperative management of Eisenmenger syndrome patients.
• To address the lack of established perioperative care guidelines for pediatric and adult ES patients.
• To base recommendations on the pathophysiological changes inherent to ES.

Main Methods:

• Literature review of existing data on Eisenmenger syndrome.
• Analysis of pathophysiological changes in ES affecting multiple organ systems.
• Synthesis of information to propose perioperative care measures.

Main Results:

• ES patients have unique perioperative risks due to chronic hypoxemia and multisystem involvement.
• Current guidelines for perioperative care in ES are limited, especially for pediatric populations.
• Understanding ES pathophysiology is crucial for developing safe surgical protocols.

Conclusions:

• Safe perioperative care for ES patients requires a comprehensive approach considering their complex physiology.
• Development of specific guidelines is essential to improve outcomes for ES patients undergoing surgery.
• This review provides a foundation for managing ES patients during the perioperative period.