{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:05:45Z","timestamp":1784037945227,"version":"3.55.0"},"reference-count":20,"publisher":"BMJ","issue":"5","funder":[{"name":"Max\u2019s Foundation"},{"DOI":"10.13039\/501100001279","name":"Great Ormond Street Hospital Charity","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001279","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"accepted":{"date-parts":[[2018,10,18]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Children with hypertrophic cardiomyopathy (HCM) have historically been considered to be high-risk candidates for general anaesthesia (GA), but there is currently a paucity of evidence regarding the safety of anaesthesia and perioperative outcomes in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical features and outcomes of all paediatric patients (&lt;18 years) with HCM undergoing GA between 2000 and 2016 were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>86 patients (median 12.4 years (IQR 6.5, 14.9)) underwent 164 separate GA procedures. Aetiology included non-syndromic disease (n=44, 56%), malformation syndromes (n=22, 26%), inborn error of metabolism (n=10, 12%) and neuromuscular disease (n=4, 5%). At the time of GA, mean maximal wall thickness (MWT) on echocardiography was 19\u2009mm (SD\u00b18\u2009mm), 23 (14%) patients had severe left ventricular hypertrophy (MWT&gt;30\u2009mm) and 35 (21%) patients had a haemodynamically significant left ventricular outflow tract (LVOT) gradient (&gt;50\u2009mm Hg). The majority (n=143, 87%) had no perioperative complications. 20 (12%) patients had minor perioperative complications: bradycardia (n=4), hypotension (n=15) or transient ST segment changes (n=1). One (0.6% of GA procedures) patient experienced a cardiac arrest during anaesthetic induction with death occurring 3 days later. Clinical parameters (including age, MWT, LVOT gradient, systolic and diastolic dysfunction) were not associated with an increased risk of complications<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the largest published series to date of paediatric patients with HCM undergoing GA, which demonstrates that, in an expert centre, patients can be anaesthetised with a relatively low perianaesthetic mortality (0.6%) and prevalence of minor complications (12%). Future studies are required to systematically identify clinical features that may predict anaesthetic risk.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2018-315366","type":"journal-article","created":{"date-parts":[[2018,11,9]],"date-time":"2018-11-09T17:48:20Z","timestamp":1541785700000},"page":"471-475","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes following general anaesthesia in children with hypertrophic cardiomyopathy"],"prefix":"10.1136","volume":"104","author":[{"given":"Gabrielle","family":"Norrish","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Forshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Woo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Claire","family":"Avanis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Field","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cervi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akane","family":"Iguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Kaski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,9]]},"reference":[{"key":"2024091723400840000_104.5.471.1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009291"},{"key":"2024091723400840000_104.5.471.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021737"},{"key":"2024091723400840000_104.5.471.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.621185"},{"key":"2024091723400840000_104.5.471.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCGENETICS.108.821314"},{"key":"2024091723400840000_104.5.471.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm342"},{"key":"2024091723400840000_104.5.471.6","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu284"},{"key":"2024091723400840000_104.5.471.7","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew041"},{"key":"2024091723400840000_104.5.471.8","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew082"},{"key":"2024091723400840000_104.5.471.9","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(85)90024-6"},{"key":"2024091723400840000_104.5.471.10","first-page":"303","article-title":"A formula to estimate the approximate surface area if height and weight be known. 1916","volume":"5","author":"Du Bois","year":"1989","journal-title":"Nutrition"},{"key":"2024091723400840000_104.5.471.11","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/j.1460-9592.2011.03645.x","article-title":"Cardiac arrest upon induction of anesthesia in children with cardiomyopathy: an analysis of incidence and risk factors","volume":"21","author":"Lynch","year":"2011","journal-title":"Paediatr Anaesth"},{"key":"2024091723400840000_104.5.471.12","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199608000-00005"},{"key":"2024091723400840000_104.5.471.13","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960290206"},{"key":"2024091723400840000_104.5.471.14","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309442"},{"key":"2024091723400840000_104.5.471.15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1961.03040420001001"},{"key":"2024091723400840000_104.5.471.16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.530303"},{"key":"2024091723400840000_104.5.471.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61685-2"},{"key":"2024091723400840000_104.5.471.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021715"},{"key":"2024091723400840000_104.5.471.19","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev286"},{"key":"2024091723400840000_104.5.471.20","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jpedsurg.2015.10.066","article-title":"Outcome of noncardiac surgery in children with congenital heart disease performed outside a cardiac center","volume":"51","author":"Ng","year":"2016","journal-title":"J Pediatr Surg"}],"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2018-315366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T06:41:45Z","timestamp":1726641705000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2018-315366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,9]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,4,18]]},"published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1136\/archdischild-2018-315366"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2018-315366","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,9]]}}}