Anesthetic Management in Adults with Congenital Heart Disease

Curr Cardiol Rep. 2022 Mar;24(3):235-246. doi: 10.1007/s11886-022-01639-y. Epub 2022 Jan 26.


Purpose of review: Adults with congenital heart disease (ACHD) are a complex and growing population that presents numerous challenges for anesthetic management. This review summarizes special considerations for anesthetic management in ACHD.

Recent findings: The adult patient with congenital heart disease may require anesthetic care for multiple surgeries and interventions throughout their lifetime. The cardiac and extracardiac manifestations of ACHD have important perioperative implications that affect anesthetic management. Recent American Heart Association/American College of Cardiology and European Society of Cardiology guidelines endorse a multidisciplinary, team-based approach to care. The cardiac anesthesiologist, endorsed as part of this multidisciplinary team, must have a thorough understanding of congenital heart disease pathophysiology and common extra-cardiac manifestations of ACHD. Safe anesthetic management in adult congenital heart disease should incorporate a multi-disciplinary approach to patient care. Anesthesiologists and centers with special expertise in ACHD care should be utilized or consulted whenever possible.

Keywords: ACHD; Cardiac anesthesia; Congenital heart disease; Extra-cardiac manifestations of ACHD.

Publication types

  • Review

MeSH terms

  • Adult
  • American Heart Association
  • Anesthetics* / therapeutic use
  • Cardiology*
  • Heart Defects, Congenital* / complications
  • Heart Defects, Congenital* / surgery
  • Humans


  • Anesthetics