Our Summary

This article is a review of recent research in the field of anesthesiology for congenital heart conditions. The authors have looked at a database of medical research to find the most important studies from 2022. They’ve focused on four key areas:

  1. How patients are admitted to the intensive care unit after having a specific heart procedure (congenital cardiac catheterization interventions).
  2. The use of drugs (antifibrinolytics) to prevent bleeding during heart surgery in children.
  3. The current state of the workforce in the US for anesthesiologists specialized in pediatric heart conditions.
  4. How the kidneys can be damaged (and how to prevent this damage) during heart surgery.

In simpler terms, this paper is about the latest research into how to care for children with heart conditions before, during, and after surgery.

FAQs

  1. What are the key topics covered in the 2022 review of literature for congenital cardiac anesthesiology?
  2. What is the current status of the pediatric cardiac anesthesia workforce in the United States as mentioned in the article?
  3. How is kidney injury and renal protection addressed during congenital heart surgery according to the 2022 review?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac surgery is to follow their post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation if recommended. It is also important to make healthy lifestyle choices such as maintaining a balanced diet, staying physically active, not smoking, and managing stress to support the healing process and long-term heart health.

Suitable For

Patients who are typically recommended for cardiac surgery include those with congenital heart disease, acquired heart conditions such as coronary artery disease, valvular heart disease, and aortic aneurysms, as well as those who have suffered a heart attack or heart failure. These patients may have symptoms such as chest pain, shortness of breath, fatigue, palpitations, or swelling in the legs, which may indicate the need for cardiac surgery. Additionally, patients with certain risk factors such as diabetes, high blood pressure, high cholesterol, smoking, obesity, or a family history of heart disease may also be recommended for cardiac surgery to prevent further complications.

Timeline

Before cardiac surgery:

  • Patient undergoes preoperative evaluation and testing to assess their overall health and suitability for surgery.
  • Patient may need to make lifestyle changes or take medications to prepare for surgery.
  • Patient meets with their cardiac surgeon and anesthesiologist to discuss the procedure and address any concerns.
  • Patient may need to fast before surgery and follow specific instructions regarding medications.
  • Patient undergoes the surgical procedure under general anesthesia.

After cardiac surgery:

  • Patient is transferred to the intensive care unit (ICU) for monitoring and recovery.
  • Patient may be on a ventilator to help with breathing and have various tubes and monitors attached.
  • Patient is closely monitored for any complications or signs of infection.
  • Patient is gradually weaned off of the ventilator and other support devices as they recover.
  • Patient may undergo physical therapy and rehabilitation to aid in their recovery.
  • Patient is discharged from the hospital and continues to follow up with their healthcare team for ongoing monitoring and care.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cardiac surgery include:

  1. What is the specific reason for recommending cardiac surgery in my case?
  2. What are the potential risks and complications associated with the surgery?
  3. What type of anesthesia will be used during the surgery and what are the potential side effects?
  4. How long is the recovery period expected to be and what kind of support will I need during this time?
  5. Are there any alternative treatment options available for my condition?
  6. How many similar surgeries have you performed in the past and what is your success rate?
  7. Will I need to make any lifestyle changes or take medications after the surgery?
  8. What is the long-term outlook for my condition after the surgery?
  9. How often will I need follow-up appointments and monitoring after the surgery?
  10. Are there any specific instructions or precautions I need to follow before and after the surgery to ensure the best possible outcome?

Reference

Authors: Stein ML, Bilal MB, Faraoni D, Zabala L, Matisoff A, Mossad EB, Mittnacht AJC, Nasr VG. Journal: J Cardiothorac Vasc Anesth. 2023 Jul;37(7):1095-1100. doi: 10.1053/j.jvca.2023.03.032. Epub 2023 Mar 29. PMID: 37085385