Anesthetic management of a patient with Fontan circulation undergoing surgery for correction of spinal stenosis

Abstract

Patients with Fontan circulation have increased cardiac and pulmonary risks. In spinal surgery these risks are increased given the nature of the surgery and patient positioning. In this case report, we describe the anesthetic technique used in an 8-year-old female with congenital heart disease and restrictive lung disease requiring spinal surgery for severe scoliosis. We will discuss our management of this complex patient including choice of general anesthetic, hemodynamic goals, ventilator settings, and inherent risks of this procedure.

Keywords

• fontan procedure; congenital heart defect; congenital scoliosis; intravenous anesthetics; hemodynamic monitoring
• respiratory function testing