Pediatric Anesthesiology
Congenital Heart Disease - 4

V. Long term and/or post-op CHD

A. Long term cyanosis or pressure overload leads to myocardial fibrosis with diminished contractility.

B. Univentricular hearts become myopathic during the 2nd-3rd decade.

C. Residual lesions
  1. Shunts
  2. Valve insufficiency
  3. Increasing PVR after shunt closure
  4. Hypertension after coarct repair
  5. Electrophysiologic sequelae
  6. Prosthetic materials
  7. Physiologic repairs which produce a systemic RV: RV functions less well than LV and may deteriorate over time
  8. CNS redidua
VI. Infective endocarditis prophylaxis

American Heart Association Recommendations, 2007:


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Greg Gordon MD