title: Successful one-lung ventilation in a patient with the Fontan circulation undergoing thoracoscopic procedure.
abstract: 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.
authors.affiliation: New York Medical College-Westchester Medical Center, Valhalla, NY, USA draginjacvetkovic@yahoo.com.
authors.forename: Draginja
authors.initials: D
authors.lastname: Cvetkovic
authors.affiliation: New York Medical College-Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Wassim
authors.initials: W
authors.lastname: Ramzy
authors.affiliation: New York Medical College-Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vitale
authors.affiliation: New York Medical College-Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Malekan
authors.affiliation: New York Medical College-Westchester Medical Center, Valhalla, NY, USA.
authors.forename: Irfan
authors.initials: I
authors.lastname: Warsy
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage; D002302:Cardiac Output / Q000502:physiology; D018729:Fontan Procedure; D006801:Humans; D008297:Male; D061810:One-Lung Ventilation / Q000379:methods*; D019990:Perioperative Care / Q000379:methods; D013906:Thoracoscopy / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D000777:Anesthetics
keywords: Fontan physiology; one-lung ventilation; pulmonary vascular resistance