The anaesthetic management of the Eisenmenger syndrome

The Eisenmenger syndrome is a form of cyanotic congenital heart disease not usually amenable to corrective surgery. It is, however, compatible with leading an active life in early adulthood and due to advances in medical therapy it is not uncommon for patients with this syndrome to live to 30 years or more. Occasionally, therefore, anaesthetists and surgeons will be required to care for these patients when they present for incidental surgery. This article reviews the appropriate measures for the safe operative and perioperative care of patients, based on an understanding of the pathophysiological changes which occur in the Eisenmenger syndrome.