Non-cardiac Surgery in a Child with Major Congenital Heart Disease: A Challenge to Safe Anaesthesia

Abstract

Surgery in children with congenital heart disease poses an increased risk of morbidity and mortality. Ideally such children should be managed in specialist cardiac centres. However, it is not unusual in developing countries for the patients to present in non-specialist centres. This was the case with a 5 month old baby who presented at our hospital with a major and severe cyanotic congenital cardiovascular anomaly for the repair of a bilateral complete cleft lip. The parents declined referal to a specialist cardiac centre. The surgery was successfully done under general anaesthesia despite the limited facilities. It is important that all anaesthetists are familiar with the basic principles involved in the management of these patients. Appropriate cardiologist consultation and close collaboration between the surgical, anaesthetic and nursing teams, is also critical to a successful outcome.

Keywords: Anaesthesia, non-cardiac surgery, congenital heart disease, non-specialist cardiac centre, limited
facilities.