The Anesthetic Management of Shone’s Complex

Shone’s complex is a rare congenital cardiac malformation characterized by four obstructive lesions affecting the left heart and aortic arch: supramitral membrane, parachute mitral valve, subaortic stenosis, and aortic coarctation, typically presenting in an incomplete form. We report the case of a 6-year-old female with a variant of Shone’s complex, which included subvalvular aortic stenosis, mitral valve stenosis, hypoplastic aortic arch, coarctation of the aorta, and patent ductus arteriosus. Surgical intervention is required in approximately 40% of cases, particularly when accompanied by early pulmonary arterial hypertension. The patient underwent surgical correction and subsequently required venoarterial extracorporeal membrane oxygenation. This report discusses the anesthetic management for a child with Shone’s complex, highlighting strategies to prevent postoperative complications, including heart failure, pneumonia, dysrhythmias, and postcoarctation syndrome.