Airway Management in Congenital Heart Disease

Airway management in patients with congenital heart disease is an important therapeutic modality to support these patients through critical illness, surgery, and other procedures. Airway management in these patients is complicated by lesser cardiopulmonary reserve due to cardiac pathophysiology, and the significant incidence of craniofacial syndromes and anatomic airway anomalies in this population. This chapter will present the developmental anatomy of the normal airway and then review major syndromes in congenital heart disease patients associated with abnormal airway anatomy. Indications for tracheal intubation and the airway examination will then be presented. Techniques for endotracheal intubation will be reviewed, followed by management of the difficult airway. Approach to extubation of the trachea will then be presented. Finally, techniques for noninvasive ventilation and tracheostomy in the patient with congenital heart disease will be reviewed.