title: Management of 1-Lung Ventilation in a Patient With Failing Fontan Circulation.
abstract: The number of patients reaching adulthood after undergoing Fontan palliation for the repair of a congenital heart defect continues to increase. In this case report, we present the anesthetic management of a patient with a history of tricuspid atresia treated with palliative Fontan repair who had developed clinical evidence of Fontan failure. He presented with septic shock secondary to streptococcal toxic shock syndrome complicated by a loculated pleural effusion. He underwent open thoracic decortication under 1-lung ventilation. Discussion focuses on the management of volume status and pulmonary vascular resistance as well as surgical implications of Fontan physiology in thoracic surgery.
authors.affiliation: From the Department of Anesthesiology, Duke University Hospital, Durham, North Carolina.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Gregory
authors.forename: Madhav
authors.initials: M
authors.lastname: Swaminathan
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Maisonave
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Machovec
mesh_terms: D000328:Adult; D018729:Fontan Procedure / Q000009:adverse effects / Q000639:trends*; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D061810:One-Lung Ventilation / Q000379:methods*; D012769:Shock / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*