title: Epidural anesthesia for cesarean delivery facilitated by minimally invasive hemodynamic monitoring in a patient with Fontan repair: a case report.
abstract: 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.
authors.affiliation: Nurse Anesthesia Program, Oakland University-Beaumont, Royal Oak, Michigan, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Wilhelm
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D002585:Cesarean Section; D003326:Coronary Circulation; D005260:Female; D018729:Fontan Procedure; D006439:Hemodynamics; D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D011247:Pregnancy