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Enteral access and fundoplication in children with congenital heart disease

Kayla B Briggs1, Jason D Fraser1

  • 1Department of Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, United States.

Seminars in Pediatric Surgery
|May 16, 2021
PubMed

Insights

Pediatric surgeons often perform non-cardiac surgeries on children with congenital heart disease (CHD). Careful pre-operative evaluation and coordinated care are crucial for safe surgical outcomes in these high-risk patients.

Area of Science:

  • Pediatric Surgery
  • Cardiology
  • Congenital Disorders

Background:

  • Congenital heart disease (CHD) affects ~1% of live births, presenting unique challenges for pediatric surgical care.
  • Many infants with CHD experience feeding difficulties and structural anomalies necessitating surgical intervention for growth and development.
  • Advancements have improved survival, leading to more adults with CHD requiring non-cardiac surgical procedures.

Purpose of the Study:

  • To review essential pre-operative assessments for pediatric patients with CHD undergoing non-cardiac surgery.
  • To outline key technical surgical considerations specific to this patient population.
  • To highlight critical anesthesia management strategies for safe outcomes.

Main Methods:

  • Review of pre-operative workup protocols.
  • Analysis of surgical techniques for enteral access and fundoplication.
  • Discussion of anesthesia management in pediatric CHD patients.

Main Results:

  • Successful non-cardiac surgery in CHD patients requires multidisciplinary collaboration.
  • Understanding pediatric CHD physiology is vital for mitigating risks.
  • Specific pre-operative, operative, and anesthetic strategies are necessary.

Conclusions:

  • Surgical intervention for children with CHD demands specialized, coordinated care.
  • Optimizing pre-operative evaluation and intra-operative management is key to reducing morbidity and mortality.
  • This review provides a framework for managing these complex pediatric surgical cases.

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