Decline in ventricular function as a result of general anesthesia in pediatric heart transplant recipients

Pediatr Transplant. 2016 Dec;20(8):1106-1110. doi: 10.1111/petr.12825. Epub 2016 Oct 30.

Abstract

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.

Keywords: anesthesia; cardiac function; echocardiography; graft function; pediatric heart transplant.

MeSH terms

  • Adolescent
  • Anesthesia, General / adverse effects*
  • Anesthetics / therapeutic use
  • Child
  • Child, Preschool
  • Diastole
  • Echocardiography
  • Female
  • Heart Transplantation*
  • Heart Ventricles / physiopathology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Systole
  • Ventricular Function*
  • Young Adult

Substances

  • Anesthetics