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Published online by Cambridge University Press: 06 February 2025
As antenatal diagnosis improves and surgical techniques are developed, the paediatric cardiac anaesthetist has an increasing role in the multidisciplinary team looking after the child undergoing cardiac surgery. Successful major operations in the neonatal period require balancing circulation and managing inotropy, coagulation and technical challenges. The anaesthetist must understand the entire perioperative period. This chapter covers the essentials of cardiac-stable anaesthesia, management of cardiopulmonary bypass and the physiological changes that can occur during children’s surgery for heart disease. Common cardiac lesions and their anaesthetic management are described in addition to the potential decompensation pathways and strategies to mitigate them. Right-to-left and left-to-right shunts, complex anatomical arrangements and anaesthesia for poor ventricular function are all covered.
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