Wilhelm Tyler
Nurse Anesthesia Program, Oakland University-Beaumont, Royal Oak, Michigan, USA.
AANA J. 2013 Aug;81(4):303-6.
With the advancement of medicine, surgery, and technology, along with the decline in mortality, anesthesia providers encounter patients with complex and rare conditions. One such example is the single ventricle congenital cardiac defect, which is corrected with Fontan reconstructive surgery. To care for patients who have undergone the Fontan procedure, the anesthesia provider needs an in-depth knowledge of the anatomy and physiology behind Fontan circulation. This article presents a brief overview of the anatomy and physiology of Fontan circulation. The case report describes a parturient who, approximately 2 decades earlier, had undergone a Fontan operation at the age of 4 years and recovered uneventfully. This article discusses the anesthetic management for the patient during cesarean delivery using epidural anesthesia, and the minimally invasive monitoring technology (Vigileo monitor, Edwards Lifesciences) to assist in monitoring the patient intraoperatively.
随着医学、外科手术和技术的进步,以及死亡率的下降,麻醉医生会遇到患有复杂罕见病症的患者。单心室先天性心脏缺陷就是这样一个例子,它通过Fontan重建手术进行矫正。为了护理接受过Fontan手术的患者,麻醉医生需要深入了解Fontan循环背后的解剖学和生理学知识。本文简要概述了Fontan循环的解剖学和生理学。病例报告描述了一名产妇,大约20年前,她在4岁时接受了Fontan手术,术后恢复顺利。本文讨论了该患者剖宫产时使用硬膜外麻醉的麻醉管理,以及使用微创监测技术(Vigileo监测仪,爱德华生命科学公司)协助术中监测患者的情况。