title: Peri-procedural risk stratification and management of patients with Williams syndrome.
abstract: Williams syndrome (WS) is a congenital, multisystem disorder affecting the cardiovascular, connective tissue, and central nervous systems in 1 in 10 000 live births. Cardiovascular involvement is the most common cause of morbidity and mortality in patients with WS, and noninvasive and invasive procedures are common. Sudden cardiovascular collapse in patients with WS is a well-known phenomenon, especially in the peri-procedural period. Detailed guidelines for peri-procedural management of patients with WS are limited. The goal of this review is to provide thoughtful, safe and effective management strategies for the peri-procedural care of patients with WS with careful consideration of hemodynamic impacts of anesthetic strategies. In addition, an expanded risk stratification system for anesthetic administration is provided.
authors.affiliation: Department of Pediatrics, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.|Department of Internal Medicine, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: R Thomas
authors.initials: RT
authors.lastname: Collins Ii
authors.affiliation: Department of Dentistry, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Collins
authors.affiliation: Department of Internal Medicine, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.|Department of Anesthesiology, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Schmitz
authors.affiliation: Department of Anesthesiology, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Hamrick
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D002319:Cardiovascular System / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D006439:Hemodynamics; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D012769:Shock / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome; D018980:Williams Syndrome / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*
keywords: Williams syndrome; anesthesia; cardiac arrest; dentistry; perioperative care; surgery