Cardiac surgery at high altitude.

Eleven children between 4 and 17 years of age underwent ligation of a patent ductus arteriosus during two medical camps in September 2003 and August 2004 at the Sonam Norboo Memorial District Hospital at Leh, Ladakh (11,400 feet above mean sea level). These children had a low mean arterial oxygen saturation while breathing room air. They were all acclimatized to high altitude. Surgery was performed under general anaesthesia with endotracheal intubation. Patients were extubated on the table. All children survived the operation and were discharged within 5-6 days following surgery. No surgical or anaesthetic complications were encountered. Simple cardiac surgical procedures such as ligation of a patent ductus arteriosus can be performed safely at high altitudes.