title: Anesthesia in adult patients with congenital heart disease.
abstract: OBJECTIVE
  Recent advances in prenatal diagnosis, interventional cardiology, pediatric cardiac surgery, anesthesia, and critical care have resulted in an increasing number of adult patients with congenital heart disease (CHD). Most of these patients will require noncardiac surgery thus presenting a new challenge for anesthesiologists. The purpose of this article is to summarize preoperative and intraoperative implications for the anesthesiologist in the noncardiac surgery setting.
  
  
  RESULTS
  These patients present with an increased risk of perioperative mortality. One of the most specific recommendations from the American College of Cardiology conference published in 2001 was that adult patients with moderate-to-severe CHD undergoing noncardiac surgery should be referred to an adult CHD center with the consultation of an expert anesthesiologist. However, though most experts agree that grown-up CHD poses an increasing risk for noncardiac surgery, no major study focusing on this topic has yet been performed.
  
  
  CONCLUSIONS
  The number of adult patients with CHD is now superior to the number of children. This is a new challenge for anesthesiologist in the noncardiac surgery settings.
authors.affiliation: Department of Anesthesiology, Louis Pradel Hospital and Claude Bernard University, Bron, France. maxime_cannesson@hotmail.com
authors.forename: Maxime
authors.initials: M
authors.lastname: Cannesson
authors.forename: Vincent
authors.initials: V
authors.lastname: Collange
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lehot
mesh_terms: D000328:Adult; D000758:Anesthesia; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D012306:Risk