• Elif A Akpek, Hülya Mutlu, and Zeynep Kayhan.
• Department of Anesthesiology, Bakent University, Ankara, Turkey. elifakpek@baskent-ank.edu.tr
• J. Cardiothorac. Vasc. Anesth. 2004 Oct 1; 18 (5): 610-2.

ObjectiveThe aim of this study was to investigate cases of difficult intubation in pediatric cardiac surgical patients and to evaluate the importance of associated congenital abnormalities.DesignRetrospective analysis.SettingDepartments of Anesthesiology and Pediatric Cardiovascular Surgery of a tertiary university hospital.ParticipantsAll children undergoing congenital heart surgery.InterventionsPatients who had difficult intubations according to their anesthetic charts were further evaluated from hospital files for demographic characteristics, associated congenital abnormalities, and perioperative airway and/or respiratory complications.Measurements And Main ResultsA total of 1,278 pediatric patients with congenital heart disease were operated on from January 1999 to July 2002. Difficult intubation was encountered in 16 cases (1.25%). Two of these were newborns, 11 were infants, and 3 were in the pediatric age group. Anterior larynx was the most common reason for difficult intubation (7 cases, 43.7%). There were associated syndromes and/or other congenital abnormalities in 8 children (50%).ConclusionThe likelihood of difficult intubation during pediatric cardiac surgery, especially in cases with other congenital pathologies should be kept in mind, and the anesthetic approach must be planned accordingly.

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