Anesthesia and LEOPARD syndrome: a review of forty-nine anesthetic exposures.
OBJECTIVE
LEOPARD syndrome is a rare congenital disease that can manifest with cardiac anomalies, multiple lentigines, ocular hypertelorism, growth retardation, and deafness. The purpose of this case series was to review the most prominent comorbidities associated with LEOPARD syndrome, and describe perioperative outcomes in a series of patients undergoing anesthesia.


METHODS
Retrospective case series review


METHODS
Tertiary care institution


METHODS
Patients diagnosed with LEOPARD syndrome who underwent surgical procedures requiring anesthesia at this institution.


METHODS
The medical and anesthesia records of patients with LEOPARD syndrome were reviewed. Demographic information, clinical features of LEOPARD syndrome, comorbidities, intraoperative and postoperative events and complications were recorded. A systematic literature review also was conducted.


RESULTS
Nine patients with LEOPARD syndrome underwent 49 procedures under general anesthesia (n = 40) or monitored anesthesia care (n = 9). The majority of operations were related to correction of cardiac anomalies (n = 20). The most common cardiac malformations were ventricular septal hypertrophy and pulmonary (or subpulmonary) stenosis, and major perioperative complications were related to severe arrhythmias and/or cardiac decompensation.


CONCLUSIONS
Dominant pathology associated with perioperative complications in patients with LEOPARD syndrome is related to cardiac disease. A large proportion of patients with this condition have ventricular septal hypertrophy, which tends to progress with age; therefore, these patients undergoing anesthesia should have recent cardiologist evaluation.
Department of Anesthesiology, Mayo Clinic, Rochester, MN; Department of Anaesthesia, National University Hospital, National University Health System, Republic of Singapore.
Tze Yeng
TY
Yeoh
Department of Anesthesiology, Mayo Clinic, Rochester, MN.
Erica D
ED
Wittwer
Department of Anesthesiology, Mayo Clinic, Rochester, MN.
Toby N
TN
Weingarten
Department of Anesthesiology, Mayo Clinic, Rochester, MN. Electronic address: sprung.juraj@mayo.edu.
Juraj
J
Sprung
D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000209:etiology; D044542:LEOPARD Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography
D000777:Anesthetics
LEOPARD syndrome; anesthesia; arrhythmia; ventricular septal hypertrophy