Sudden death common among those with three-chambered hearts

Chuck Biedka
| Saturday, May 7, 2011

NEW KENSINGTON -- People born with three-chambered hearts are at high-risk of sudden death, said Dr. Andrew Herlich, chief of anesthesia at UPMC Mercy hospital in Pittsburgh.

Herlich did not know Miciah Bonzani, 16, who died Thursday after suffering complications after being anesthetized to have her wisdom teeth removed Tuesday, according to her family. He could not comment on her case specifically.

But that she suffered cardiac arrest while undergoing the dental procedure "could've been pure happenstance and totally unrelated to anything that was done in the dental office," said Herlich, who serves as a liaison between the American Society of Anesthesiologists and the American Dental Association.

"There are many patients who have these complex congenital birth defects that have sudden death," he said. "It could happen to them at home while watching TV, eating, bathing, just walking outside or putting on their clothes. They could be walking down the street and die suddenly."

In 1995, when Bonzani was 9-months-old, she underwent an operation known as a Fontan procedure to repair her deformed heart. She also had a second surgery in her first year

Before the procedure was developed, children born with a three-chambered heart were lucky to live a few weeks, Herlich said. Although with the procedure many people are living into adulthood, there is not yet any long-term data.

"You really have a very guarded life," Herlich said. "Day-to-day functionality is different in patients who have Fontan physiology.

"It's not the normal heart. It's very different plumbing," he said.

"Her physiology by itself is enough that sudden death could have occurred," he said. "A patient born with a three-chambered heart is really a big challenge."

According to the American Society of Anesthesiologists, advances in patient safety have led to a dramatic decrease in anesthesia-related deaths over the past 25 years, from two deaths per 10,000 anesthetics administered to one death per 200,000 to 300,000 anesthetics administered.

Although as with most medical procedures there is a small risk of complications and rarely death, most healthy people don't have any problems with general anesthesia, according to the Mayo Clinic. Complications are rare and occur more frequently in older adults or in people who have medical problems.

Medical conditions involving the heart, lungs or kidneys can increase the risk of complications, including heart attack and death. Other factors that can increase risk include smoking, alcohol use, allergies, sleep apnea and obesity.

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