RT Book, Section A1 Zaleski, Katherine L. A1 Rodriguez, Maricarmen Roche A1 Nasr, Viviane G. A2 Ellinas, Herodotos A2 Matthes, Kai A2 Alrayashi, Walid A2 Bilge, Aykut SR Print(0) ID 1176457962 T1 Anesthesia for Cardiovascular Procedures T2 Clinical Pediatric Anesthesiology YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781259585746 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176457962 RD 2024/03/28 AB FOCUS POINTSFetal cardiac development begins at approximately 22 days of gestation. The fetal circulation allows for preferential shunting of oxygenated blood to the brain and heart.Beginning at birth, the cardiovascular system undergoes drastic physiological changes as it transitions from a parallel to a series circulation. In the transitional circulation, the fetal shunts (ductus arteriosus, ductus venosus, and foramen ovale) close functionally and eventually, anatomically.Normal vital signs value change with age, reaching adult values in adolescence.Congenital heart disease is the most common form of birth defect with an incidence of between 4 and 7 per 1000 live births. Patients with congenital heart disease may have associated extracardiac anomalies and genetic syndromes.Congenital heart disease (CHD) can be classified as cyanotic or acyanotic, depending on the presence or absence of right-to-left shunting.The magnitude of shunting and its hemodynamic significance depends on the location and size of the shunt as well as the pressure gradient across the shunt and the relative compliances of the downstream chambers or resistances of the downstream vessels.Pediatric heart failure can be related to volume- or pressure-overload. It can occur in structurally normal heart with primary cardiomyopathy (dilated, hypertrophic, or restrictive) or secondary cardiomyopathy due to arrythmia, ischemic, toxicity, infection, or infiltrative diseases.The approach to the patient with CHD undergoing noncardiac surgery should be systematic and team-based.