{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:23:35Z","timestamp":1790630615388,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T00:00:00Z","timestamp":1746921600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Advances in surgical and medical management of congenital heart disease have improved survival rates, leading to a growing population of adult congenital heart disease (ACHD) patients requiring specialized perioperative care. Studies indicate that ACHD patients undergoing non-cardiac surgery (NC surgery) have increased mortality and morbidity risks compared to the general population, with complication rates particularly high in those with complex defects, such as Fontan circulation, Eisenmenger syndrome, or cyanotic congenital heart disease. Key perioperative concerns include hemodynamic instability, arrhythmias, thromboembolic events, and bleeding risks. Additionally, comorbidities, such as frailty, chronic inflammation, or respiratory disease, further complicate perioperative management. Multidisciplinary collaboration is critical, involving cardiologists, anesthesiologists, and surgeons to optimize preoperative preparation and perioperative monitoring. Preoperative risk stratification is essential, integrating congenital heart lesion complexity, functional status, and procedural risk. This review underscores the importance of structured preoperative assessment, appropriate risk evaluation, and individualized perioperative strategies to improve surgical outcomes in ACHD patients undergoing NC surgery. Further research is needed to refine risk prediction models and optimize perioperative protocols tailored to this unique patient population.<\/jats:p>","DOI":"10.3390\/jcm14103340","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T09:13:38Z","timestamp":1747041218000},"page":"3340","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Perioperative Risk in Adults with Congenital Heart Disease Undergoing Non-Cardiac Surgery: Challenges and Tailored Strategies"],"prefix":"10.3390","volume":"14","author":[{"given":"Magalie","family":"Ladouceur","sequence":"first","affiliation":[{"name":"Service de Cardiologie, University Hospitals of Geneva, 1205 Geneva, Switzerland"},{"name":"Service de Cardiologie, Centre Hospitalier Universitaire Vaudois, Universit\u00e9 de Lausanne, 1011 Lausanne, Switzerland"},{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, 92350 Le Plessis-Robinson, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6593-2330","authenticated-orcid":false,"given":"Lena","family":"Valacco","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, Centre Hospitalier Universitaire Vaudois, Universit\u00e9 de Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9199-4415","authenticated-orcid":false,"given":"Zied","family":"Ltaief","sequence":"additional","affiliation":[{"name":"Department of Adult Intensive Care Medecine, Centre Hospitalier Universitaire Vaudois, Universit\u00e9 de Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5899-291X","authenticated-orcid":false,"given":"Tobias","family":"Rutz","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, Centre Hospitalier Universitaire Vaudois, Universit\u00e9 de Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8695-0503","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Hascoet","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, 92350 Le Plessis-Robinson, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-288X","authenticated-orcid":false,"given":"Judith","family":"Bouchardy","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, University Hospitals of Geneva, 1205 Geneva, Switzerland"},{"name":"Service de Cardiologie, Centre Hospitalier Universitaire Vaudois, Universit\u00e9 de Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e017704","DOI":"10.1161\/JAHA.120.017704","article-title":"Survival in Children with Congenital Heart Disease: Have We Reached a Peak at 97%?","volume":"9","author":"Mandalenakis","year":"2020","journal-title":"J. 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