title: A patient with surgically unrepaired single ventricle and uncontrolled amiodarone-induced thyrotoxicosis for emergent thyroidectomy.
abstract: We present the case of a 20-year-old woman with a history of hypoplastic left heart syndrome, D-transposition of the great arteries, and mitral/pulmonary valve atresia without surgical palliation, who was admitted with persistent atrial flutter/fibrillation and worsening cardiac function from amiodarone-induced thyrotoxicosis. Despite maximal medical therapy, she continued to have uncontrolled thyrotoxicosis and underwent successful emergent thyroidectomy under general anesthesia. With advances in the treatment of congenital heart disease, more patients are surviving to adulthood and require emergent noncardiac surgery. Therefore, anesthesiologists must understand the principles for managing patients with congenital heart disease and how the patient's physiology may affect the anesthetic plan.
authors.affiliation: From the Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Downey
authors.forename: Samuel
authors.initials: S
authors.lastname: Rodriguez
authors.forename: David
authors.initials: D
authors.lastname: Clendenin