Perioperative and Anesthetic Considerations in Shone's Complex

Semin Cardiothorac Vasc Anesth. 2024 Mar;28(1):28-37. doi: 10.1177/10892532231223840. Epub 2023 Dec 22.

Abstract

Shone's complex is a congenital cardiac disease consisting of the following four lesions: parachute mitral valve, supravalvar mitral ring, subaortic stenosis, and aortic coarctation. Though not all components are required for a diagnosis, the end result is both left ventricular inflow and outflow obstruction, which typically present in patients as congestive heart failure. The complex pathology requires careful management and surgical decision-making to ensure an optimal outcome. This review will focus on the anatomy, physiology, and perioperative anesthetic management of patients with Shone's complex.

Keywords: Shone's complex; cardiac anesthesia; cardiac surgery; congenital heart disease; intraoperative transesophageal echocardiography; left ventricular outflow obstruction; mitral valve.

Publication types

  • Review

MeSH terms

  • Anesthetics*
  • Aortic Coarctation* / surgery
  • Heart Defects, Congenital* / diagnosis
  • Heart Defects, Congenital* / surgery
  • Humans
  • Mitral Valve / pathology
  • Mitral Valve / surgery
  • Mitral Valve Stenosis* / surgery

Substances

  • Anesthetics