Anesthetic and perioperative management of 1000 cases of congenital heart surgery - Massive vasodilator therapy and early extubation

We report our anesthetic and perioperative management of 1000 cases of congenital heart surgery in Okayama University Medical School over the last six and a half years. Most of these patients were anesthetized by fentanyl and all patients were managed in our ICU postoperatively. Although hospital death rate in all patients was 4.5%, almost half of dead patients were patients with hypoplastic left heart syndrome. Neonatal mortality rate has been still high, 18.9%, which has been our main problem. We tried to extubate patients with complex congenital heart diseases earliar postoperatively for the last three years, using massive dose of vasodilators without nitric oxide.