Cvetkovic Draginja, Ramzy Wassim, Vitale Salvatore, Malekan Ramin, Warsy Irfan
New York Medical College-Westchester Medical Center, Valhalla, NY, USA
New York Medical College-Westchester Medical Center, Valhalla, NY, USA.
Semin Cardiothorac Vasc Anesth. 2014 Dec;18(4):379-81. doi: 10.1177/1089253214542252. Epub 2014 Jul 9.
Over the course of the past 4 decades, the survival of patients with the Fontan circulation has improved and today they often present for noncardiac surgery anesthesia care. In patients with the Fontan circulation, pulmonary blood flow is passive and anesthetic management is directed at reducing pulmonary vascular resistance and maintaining adequate cardiac output. One-lung ventilation can have unfavorable effects on the Fontan circulation due to hypoxia, hypercarbia, and increased airway pressure. We present a case of successful one-lung ventilation in a patient with the Fontan circulation and describe the perioperative anesthetic management.
