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Perioperative and Anesthetic Considerations in Shone's Complex
Leah Landsem1, Nicholas Brown2, Ryan Cox3
1Division of Paediatric Cardiac Anesthesiology, Department of Anesthesiology, Seattle Children's Hospital, Seattle, WA, USA.
Seminars in Cardiothoracic and Vascular Anesthesia
|December 22, 2023
Summary
Shone's complex, a congenital heart disease, causes left ventricular obstruction. This review covers its anatomy, physiology, and anesthetic management for better patient outcomes.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Shone's complex is a rare congenital cardiac disease.
- It involves four potential lesions: parachute mitral valve, supravalvar mitral ring, subaortic stenosis, and aortic coarctation.
- The primary consequence is obstruction of left ventricular inflow and outflow, often leading to congestive heart failure.
Purpose of the Study:
- To provide a comprehensive review of Shone's complex.
- To detail the complex's anatomy and physiology.
- To outline the perioperative anesthetic management strategies for patients with Shone's complex.
Main Methods:
- Literature review focusing on anatomical, physiological, and anesthetic aspects.
- Synthesis of current understanding regarding Shone's complex management.
- Analysis of perioperative considerations for surgical intervention.
Main Results:
- Detailed description of the four characteristic lesions of Shone's complex.
- Explanation of the combined impact on left ventricular function.
- Identification of key anesthetic challenges and management principles.
Conclusions:
- Shone's complex necessitates a thorough understanding of its multifaceted pathology.
- Optimal surgical and anesthetic management is crucial for improving patient outcomes.
- This review serves as a resource for clinicians managing this complex condition.
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