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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 129-139
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Anaesthetic implications of grown-up congenital heart disease

A. T. Lovell

University Department of Anaesthesia, Level 7, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, UKE-mail: Tim.Lovell@bristol.ac.uk

Keywords: complications, grown-up congenital heart disease; pathophysiology; surgery, cardiovascular

The first 150 words of the full text of this article appear below.

Congenital heart disease (CHD) is one of the most common inborn defects, occurring in approximately 0.8% of newborn infants.75 98 The frequency of the common congenital cardiac defects is shown in Table 1. In the era before the development of paediatric cardiac surgery, fewer than 20% of these children survived to adulthood.59 Now, more than 85% of children with CHD can expect to live into adulthood. This dramatic success has created an ever increasing population of young adults with grown-up congenital heart disease (GUCHD).22 It is expected that shortly there will be more adults with CHD than children.24 There are approximately 800 000 adults in the USA with CHD,98 and recent estimates suggest that 1600 new cases with moderate-to-severe complexity are referred to GUCHD units within the UK each year.103 The nature of the underlying cardiac problems that these GUCHD patients have, shown in Table 2, is substantially different . . . [Full Text of this Article]

General considerations

Anaesthetic technique

Infective endocarditis

Hypoxaemia

Pulmonary hypertension

Eisenmenger syndrome

Palliative shunts

Arrhythmias

Specific conditions

Atrial septal defects
Cavopulmonary anastomoses
Tetralogy of Fallot
Ventricular septal defects

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