@Article{CHD.2020.011523,
AUTHOR = {Michela Palma, Giancarlo Scognamiglio, Flavia Fusco, Assunta Merola, Anna Correra, Diego Colonna, Emanuele Romeo, Berardo Sarubbi},
TITLE = {Preoperative Risk Assessment and Perioperative Management of Adults with  Congenital Heart Disease Undergoing Non-Cardiac Surgery},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {1},
PAGES = {33--49},
URL = {http://www.techscience.com/schd/v15n1/39376},
ISSN = {3071-1738},
ABSTRACT = {Adults with congenital heart disease (ACHD) constitute a growing 
population with complex cardiac physiopathology and frequent extra-cardiac
involvement. The recent dramatic improvement of their life expectancy has 
resulted in an increasing proportion of ACHD patients requiring non-cardiac 
surgery. While a large body of evidence demonstrated the importance of an 
accurate risk assessment in patients with acquired heart disease before noncardiac surgery in order to reduce perioperative morbidity and mortality and 
detailed algorithms have been released by international societies, no specific 
guidelines are available for the perioperative management in this population. 
Nonetheless, understanding the complex anatomy and unusual physiology of 
both repaired and unrepaired congenital heart disease is paramount to meet the 
unique needs of these patients and to ensure an adequate perioperative 
management and prevention of complications. Furthermore, anaesthesiologists 
and surgeons unfamiliar with congenital heart disease may be not aware of the
variety of different disease-related issues, which may arise in ACHD patients 
during the hemodynamic changes of the perioperative phase, with possible 
severe adverse effects on cardiac performance. We herein review the limited 
evidence from the literature and summarize our personal experience in a tertiary 
ACHD centre in order to propose a first structured approach for preoperative risk 
assessment and perioperative management to reduce the mortality and morbidity 
risk in adults with congenital heart disease undergoing non-cardiac surgery.},
DOI = {10.32604/CHD.2020.011523}
}