This review highlights the published literature in 2025 that pertains to the anesthetic management of patients with congenital heart disease. Four major themes are discussed: (i) anesthesia for adults with congenital heart disease (ii) perioperative blood management and cardiopulmonary bypass-associated decision-making (iii) enhanced recovery after cardiac surgery and (iv) noncardiac procedural safety and workforce sustainability.
GoodmansonMMLathamGJLandsemLMRossFJ. The year in review: anesthesia for congenital heart disease 2022. Semin CardioThorac Vasc Anesth. 2023;27(2):114-122.
2.
WadleMLandsemLLathamGRossF. The year in review: anesthesia for congenital heart disease 2023. Semin CardioThorac Vasc Anesth. 2024;28(2):91-99.
3.
GoodmansonMMChauDFLandsemLMLathamGJ. The year in review: anesthesia for congenital heart disease 2024. Semin CardioThorac Vasc Anesth. 2025;29(2):103-115.
4.
RefakisCMarshBDaveASchwartzLI. Patients with adult congenital heart disease presenting for noncardiac surgery. Curr Opin Anaesthesiol. 2026;39(1):46-51.
5.
FriedrichAJRadkeROrwatS, et al.Non-cardiac surgeries in adults with congenital heart disease -influence of complexity of disease and estimated risk of surgery on adverse events. Eur J Intern Med. 2026;143:106514.
6.
GurvitzMKriegerEVFullerS, et al.2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. J Am Coll Cardiol. 2026;87(7):822-976.
7.
TaferNLangouetEAlacoqueX, et al.Guidelines for anaesthesia of adults with congenital heart disease in non-cardiac surgery. Anaesth Crit Care Pain Med. 2025;44(4):101540.
8.
OsawaTMachino-OhtsukaTNumataR, et al.Clinical characteristics and outcomes of cardiac surgery and transcatheter procedures in patients with adult congenital heart disease-insights from Japanese registry data. Circ J. 2025;89(7):946-956.
9.
AhmedMDolgnerSErmisP, et al.Risk prediction for surgery on adults with congenital heart disease: nonprocedural clinical and social factors predominate. J Thorac Cardiovasc Surg. Published online November 8, 2025.
10.
BiezeMPooleODelfaniAHeggieJSalvatoriM. Characteristics and risk profile of the over fifty adult congenital heart surgical population, a retrospective cohort. Front Cardiovasc Med. 2025;12:1568920.
11.
GiambertiAFerreroPCaldaroniF, et al.The appraisal of adults with congenital heart disease: Lesson from comparison of surgical outcomes. Pediatr Cardiol. 2025;46(4):930-938.
12.
BaumgartnerHDe BackerJBabu-NarayanSV, et al.2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J. 2021;42(6):563-645.
13.
LongFZhangYLuoM, et al.Goal-directed perfusion to reduce acute kidney injury after pediatric cardiac operation. Ann Thorac Surg. 2025;119(4):891-898.
14.
YoneyamaFVan DykeTRBrenesJ. Quality indicators in pediatric cardiopulmonary bypass: current perspectives and future directions. Perfusion. Published online October 30, 2025.
15.
BiererJDStanzelRHendersonM, et al.Complement activation by the artificial surface of cardiopulmonary bypass is a persistent clinical problem. Sci Rep. 2025;15(1):27643. Published 2025 Jul 29.
16.
PoerteceneAKleinerSTrachteL, et al.Pre-bypass ultrafiltration reduces cytokine burden of blood prime in pediatric cardiac surgery. Sci Rep. 2025;15(1):31271. Published 2025 Aug 25.
17.
SwanEALahrBDAl-HunitiAH. Thrombin generation in pediatric cardiac surgery patients: a prospective single-center cohort study. Anesthesiology. 2025;143(1):84-97.
18.
SiemensKParmarKHarrisJHuntBJTibbySM. Fibrinolytic activity in infants undergoing cardiac surgery on cardiopulmonary bypass with routine tranexamic acid: a prospective cohort substudy within the FIBrinogen CONcentrate randomised control trial. Eur J Anaesthesiol. 2025;42(5):389-397.
19.
SunthankarSDHillKDJacobsJP, et al.Methylprednisolone for infant heart surgery: subpopulation analyses of a randomized controlled trial. Crit Care Med. 2025;53(7):e1470-e1480.
20.
SunthankarSDHillKDJacobsJP, et al.Reexploring the STRESS trial: subgroup postoperative outcomes following methylprednisolone for infant heart surgery. Pediatr Cardiol. 2026;47(3):1026-1034. doi:10.1007/s00246-025-03875-9.
21.
HillKDKoernerJHongH, et al.A Bayesian re-analysis of the STRESS trial. Am Heart J. 2026;292:107282.
22.
HillKDKannankerilPJJacobsJP, et al.Methylprednisolone for heart surgery in infants - a randomized, controlled trial. N Engl J Med. 2022;387(23):2138-2149.
23.
Abu-ShawerOE'marARJaberARTailakhSAbu-ShawerAAl-HaddadinC. Enhanced recovery after pediatric cardiac surgery: a meta-analysis. Avicenna J Med. 2025;15(2):80-85.
24.
MeierSBorzelJHellnerN, et al.Enhanced Recovery after Surgery (ERAS) in pediatric cardiac surgery: status quo of implementation in Europe. J Cardiothorac Vasc Anesth. 2025;39(1):177-186.
25.
CatenaDMeierSSchindlerE, et al.Enhanced recovery after surgery: implementation in the preoperative and postoperative management of children undergoing cardiac surgery is low and differs across European centers. J Cardiothorac Vasc Anesth. 2025;39(11):3065-3074.
26.
AvşarMKGüzelYÖnselİÖKıratB. Extubation on the operating table in pediatric cardiac surgery: a multicenter analysis of 986 patients. Pediatr Cardiol. 2026;47(4):1459-1469. Epub 2025 Jun 18.
27.
KaushikJVijayakumarRRamanathP, et al.Routine use of an on-table extubation protocol in pediatric cardiac surgery-our experience with life in the fast lane. World J Pediatr Congenit Heart Surg. 2025;16(4):483-492.
28.
TapiocaVCaetanoLGibicoskiTAlrayashiWAmaralS. On-Table extubation after pediatric cardiac surgery: a systematic review. Paediatr Anaesth. 2026;36(1):5-20. Epub 2025 Aug 13.
29.
EinhornLMKharaschEDLimJ, et al.Combined pecto-intercostal fascial plane and rectus sheath blocks versus local infiltration for pain management following pediatric cardiac surgery: a randomized clinical trial. Anesth Analg. Published online October 1, 2025.
30.
MadkourMAFAAbueldahabEIBElelaAHAYoussefMFGadoAA. Analgesic efficacy of bilateral ultrasound-guided transversus thoracic muscle plane block versus erector spinae plane block in pediatric patients undergoing corrective cardiac surgeries: a randomized controlled study. J Cardiothorac Vasc Anesth. 2025;39(6):1495-1505.
31.
GopalakrishnanRMShindeNMeghalakshmiAR, et al.Erector spinae plane block versus retrolaminar block for perioperative analgesia in pediatric cardiac surgery: a randomized, double-blinded, noninferiority clinical trial. J Cardiothorac Vasc Anesth. 2025;39(12):3455-3464.
32.
WegnerBFMWegnerGRMAriasJANascimentoTS. Preemptive regional nerve blocks for sternotomy in pediatric cardiac surgery: a Bayesian network meta-analysis. Braz J Anesthesiol. 2025;75(5):844652.
33.
RussellGCEinhornLM. Regional anesthesia with fascial plane blocks for pediatric cardiac surgery with sternotomy: a narrative review. Anesth Analg. 2026;142(3):507-517.
34.
JijehAMZShaathGAIsmailSR, et al.Optimizing recovery: early versus delayed chest tube removal in pediatric cardiac surgery patients: a randomized controlled trial. Crit Care Explor. 2025;7(6):e1271.
35.
ShahzadMAlharthyMAlanaziW, et al.Comparative effectiveness of high-flow nasal cannula versus non-invasive ventilation for post-extubation respiratory support after pediatric cardiac surgery: a systematic review and meta-analysis of observational cohorts. Cureus. 2025;17(12):e98553.
36.
CulpCManningMW. How we would use enhanced recovery after cardiac surgery: what we would Do for ourselves during the perioperative period. J Cardiothorac Vasc Anesth. 2025;39(8):1950-1960.
37.
NasrVGStaffaSJFaraoniDDiNardoJA. Trends in mortality rate in patients with congenital heart disease undergoing noncardiac surgical procedures at children’s hospitals. Sci Rep. 2021;11(1):1543.
38.
SulkowskiJPCooperJNMcConnellPI, et al.Variability in noncardiac surgical procedures in children with congenital heart disease. J Pediatr Surg. 2014;49(11):1564-1569.
39.
KuntzMTStaffaSJBerryJGNasrVG. Hospital volume and noncardiac surgery outcomes for patients with congenital heart disease. J Cardiothorac Vasc Anesth. 2026;40(1):143-150.
40.
FozCStaffaSFaraoniDDiNardoJANasrVG. Comparison over two eras of perioperative adverse outcomes in children with and without congenital heart disease undergoing noncardiac surgery. Paediatr Anaesth. 2026;36(1):57-66.
41.
NasrVGKuntzMChinV, et al.Intraoperative cardiac events in pediatric patients with congenital heart disease undergoing noncardiac procedures: analysis of a large multicenter registry. Anesthesiology. 2026;144(2):314-324. Epub 2025 Oct 3.
42.
ChenaultKRahmanGRGauvreauK, et al. Incidence of high severity anesthesia related adverse events with increasing PREDIC3T risk category in congenital cardiac catheterization: a review of the C3PO database. Paediatr Anaesth. 2026;36(4):379-387.
43.
YehMJBjornlundEGauvreauK, et al.Formulation of quality improvement methodology for risk mitigation in congenital cardiac catheterization. Pediatr Cardiol. 2025;46(7):1992-2003.
44.
FashinaOAVogelERSwanEA, et al.General endotracheal anesthesia vs total intravenous anesthesia for children undergoing low-risk cardiac catheterization. Pediatr Cardiol. 2026;47(1):324-331.
45.
SmithAHHealanSJStaudtGE, et al.Relationship between anaesthesia strategy and intracardiac hemodynamics during paediatric cardiac catheterisation. Cardiol Young. 2025;35(9):1863-1870.
46.
BrownMLDorsteAAdamsPS, et al.Proposed quality metrics for congenital cardiac anesthesia: a scoping review. Anesth Analg. 2025;140(2):397-408.
47.
DeutschNGrantSZabalaL, et al.The current state of pediatric cardiac anesthesiology staffing in the United States. Anesth Analg. 2026;142(2):232-244.
48.
HuffmanJGlenskiTTaylorCLataN. The current state of pediatric cardiac anesthesiology staffing in the United States. Anesth Analg. 2026;142(3):e38-e39.
49.
CarulloPKhanSNause-OsthoffR, et al.Understanding pediatric anesthesiology fellowship interest: a national survey of the resident experience. Paediatr Anaesth. 2025;35(3):223-231.
