Decline in ventricular function as a result of general anesthesia in pediatric heart transplant recipients
Corresponding Author
Justin J. Elhoff
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Correspondence
Justin Elhoff, Sections of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorShahryar M. Chowdhury
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorCarolyn L. Taylor
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorMarc Hassid
Division of Pediatric Anesthesia, Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorAndrew J. Savage
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorAndrew M. Atz
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorRyan J. Butts
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorCorresponding Author
Justin J. Elhoff
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Correspondence
Justin Elhoff, Sections of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, TX, USA.
Email: [email protected]
Search for more papers by this authorShahryar M. Chowdhury
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorCarolyn L. Taylor
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorMarc Hassid
Division of Pediatric Anesthesia, Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorAndrew J. Savage
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorAndrew M. Atz
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorRyan J. Butts
Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Search for more papers by this authorAbstract
Echocardiography is frequently performed under anesthesia during procedures such as cardiac catheterization with EMB in pediatric HTx recipients. Anesthetic agents may depress ventricular function, resulting in concern for rejection. The aim of this study was to compare ventricular function as measured by echocardiography before and during GA in 17 pediatric HTx recipients. Nearly all markers of ventricular systolic function were significantly decreased under GA, including EF (−4.2% ±1.2, P < .01) and RV FAC (−0.05 ± 0.02, P = .04). Subjects in the first post-transplant year (n = 9) trended toward a more significant decrease in EF vs those beyond the first post-transplant year (n = 8; −6.0% ±1.2 vs −2.1 ± 2.0, P = .1). This information quantifies a decline in biventricular function that should be expected in pediatric HTx recipients while under GA and can assist the transplant clinician in avoiding unnecessary treatment of transient GA-induced ventricular dysfunction.
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