Seminars in Cardiothoracic and Vascular Anesthesia

 

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 5, No. 1, 31-39 (2001)
DOI: 10.1053/scva.2001.21549

Anesthetic Implications of the Fontan Procedure for Single Ventricle Physiology

Julie A. Gaca

Department of Anesthesiology, Rush Medical College Rush-Presterian-St. Luke's Medical Center

William I. Douglas

Departments of Cardiovascular and Thoracic Surgery and Pediatrics, Rush Medical College Rush-Presterian-St. Luke's Medical Center

Steve D. Barnes

Departments of Anesthesiology and Pediatrics, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL.

The Fontan procedure is the operation of choice for patients considered to be candidates for definitive palliation of single ventricle physiology. Anesthetic technique for the Fontan procedure is not well described in the literature, and the medical and surgical treatment of these patients is rapidly evolving. With an understanding of the anatomy and phys iology of the Fontan patient, a safe and effective anesthetic can be executed. An understanding of the changes that occur during the perioperative period is critical. This article focuses on a review of single ventricle physiology and Fon tan physiology, preoperative assessment and risk factors for the Fontan procedure, intraoperative management, and management of low cardiac output in the postbypass period.


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