Enteral access and fundoplication in children with congenital heart disease

Congenital heart disease (CHD) is the most frequently occurring congenital disorder and affects approximately 1% of live births.(1,2) Advancements in supportive technology and surgical techniques have allowed many of these children to live into adulthood with reductions in morbidity and mortality.(3,4) During infancy, many children with CHD are plagued with co-existing structural anomalies and/or feeding disorders that make adequate oral intake impossible.(5) Pediatric surgeons are frequently consulted for enteral access and/or fundoplication to ensure proper growth and development while preventing potential hemodynamic instability caused by significant reflux events. The successful execution of a non-cardiac surgery in a child with significant cardiac risk factors requires the coordination and expertise of multiple providers with a deep understanding of pediatric CHD physiology to ensure a safe outcome. We review critical pre-operative workup, technical operative aspects, and anesthesia considerations in this unique patient population. (C) 2021 Elsevier Inc. All rights reserved.