J.Jpn. Surg. Soc.. 106(5): 334-337, 2005

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Feature topic

CLINICAL INFORMATION AND MANAGEMENT IN PATIENTS WITH ADULT CONGENITAL HEART DISEASE AT NON CARDIAC SURGERY

Untreated or palliated congenital heart disease has the strong impact on the outcomes of surgery for noncardiovascular disease that accrues with age. However, excellent guidelines have not been published yet that provide ideal information and expert opinion for patients and doctors in assessing adult congenital heart disease (ACHD). In the global risk assessment for such a condition, American College of Cardiology―American Heart Association (ACC/AHA) guidelines can be helpful although developed exclusively from populations with acquired heart disease. The first necessity is to clarify the diagnosis. The second is preoperative hemodynamic assessment according to the specific physiology and anatomy. The third is to evaluate the intensity of expected hemodynamic stress by proposed operation. The last is to elucidate co-morbid conditions. In addition to global risk assessment, Risk factors unique to ACHD must be carefully considered. Under complete assessment of these risk factors by the staff who have sufficient experience or training in the management of ACHD, the optimal, effective and meticurous cares can be provided to patients with ACHD encountered at noncardiac surgery.

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