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.
De LevalMRDeanfieldJE. Four decades of Fontan palliation. Nat Rev Cardiol. 2010;7:520-527.
2.
KhambadkoneS. The Fontan pathway: what’s down the road?Ann Pediatr Cardiol. 2008;1:83-92.
3.
MajimaNKagawaTSuzukiTKurosakiA. Successful one-lung ventilation in a patient with the Fontan circulation undergoing thoracotomy: a case report. J Anesth. 2012;26:453-455.
4.
YukiKCasteAUezonoS. Anesthetic management of noncardiac surgery for patients with single ventricle physiology. J Anesth. 2011;25:247-256.
