title: [Anesthetic Management of an Adult Patient Complicated with Tricuspid Atresia Maladapted for Fontan Operation Who Underwent Laparoscopic Cholecystectomy].
abstract: With the advance of diagnosis and therapeutic management for congenital heart disease, increasing numbers of the non-cardiac surgery were performed on patients with post-cardiac surgery, such as the radical operations and Fontan operation. However, there are adult patients who have not received Fontan operation lacking indication. We experienced a case of adult surgical patient for laparoscopic cholecystectomy complicated with tricuspid atresia who was not indicated for Fontan surgery. A 28-year-old man diagnosed with cholecystolithiasis was scheduled for laparoscopic cholecystectomy. He had undergone bidirectional Glenn and Blalock-Taussig shunt, but not undergone Fontan surgery for hypoplasia of the pulmonary artery and low left ventricular function. To reduce the influence of intraabdominal pressue on hemodynamics, the insufflations pressure was maintained at 8 mmHg during pneumoperitoneum. To assist ventricular function, dopamine and carperitide were administered perioperatively. We should carefully manage such a patient during perioperative period by understanding the hemodynamic state and considering the influence of pneumoperitoneum and posture.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Miura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D018729:Fontan Procedure; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy; D010195:Pancreatitis / Q000150:complications / Q000601:surgery; D018785:Tricuspid Atresia / Q000150:complications / Q000601:surgery*