OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Andreas HoeftAnesthesia in adults with congenital heart diseaseBaehner, Torsten; Ellerkmann, Richard K.Author Information Department of Anesthesiology and Intensive Care, University Hospital Bonn, Bonn, Germany Correspondence to Torsten Baehner, Department of Anesthesiology and Intensive Care, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Tel: +49 228 287 14114; fax: +49 228 287 14125; e-mail: [email protected] Current Opinion in Anaesthesiology: June 2017 - Volume 30 - Issue 3 - p 418-425 doi: 10.1097/ACO.0000000000000468 Buy Metrics Abstract Purpose of review The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. Recent findings About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers. However, preoperative risk assessment for anesthesia in these patients is complex due to underlying cardiac morbidity and substantial CHD-associated noncardiac morbidity. In addition to clinical assessment and echocardiography, biomarker measurement may be a clinically useful tool to estimate severity of heart failure in CHD patients. The high negative predictive value of NT-proBNP makes it particularly valuable as a screening tool. Further, morbidity and mortality in ACHD patients are mainly caused by arrhythmias and therefore are also relevant for perioperative management. Adverse events and perioperative death in ACHD patients in cardiac and noncardiac surgery are frequently related to intraoperative anesthetic care. Summary Medical progress in treatment of CHD has shifted morbidity and mortality of these patients largely to adulthood. Future investigations including risk stratification of ACHD patients are necessary to further improve perioperative management, especially for low-risk and high-risk noncardiac management. Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.