What Every Anesthesiologist Must Know About Congenital Heart Disease

In Canada, Europe and the United States, more than five million adults suffer complications of congenital heart disease (CHD), which recently surpassed the number of children with CHD. I provided anesthesia during open-heart surgery for children undergoing repair of CHD for six years at University of California, San Francisco and for three years at Children’s Hospital of Orange County. The usual anesthesia residency experience only includes a few adults with CHD undergoing general surgery. Fellowships in cardiac anesthesia were not formalized according to the Accreditation Council for Graduate Medical Education (ACGME) until the last several years. Although “Adult Cardiothoracic Anesthesiology” is now an ACGME fellowship, it only allows two months of electives overall, and merely strongly encourages two weeks of CHD. An ACGME pediatric anesthesia fellowship year requires two months of CHD surgery. With this limited experience dealing with CHD, there is discussion in some hospitals of requiring a second year of fellowship, totaling six years of training after medical school, to conduct anesthesia for CHD.