Book contents
- Congenital Cardiac Anesthesia
- Congenital Cardiac Anesthesia
- Copyright page
- Dedication
- Contents
- Contributors
- Introduction
- Chapter 1 A Congenital Heart Disease Primer
- Section 1 Left-to-Right Shunts
- Section 2 Right-Sided Obstructive Lesions
- Section 3 Left-Sided Obstructive Lesions
- Section 4 Complex Mixing Lesions
- Section 5 Single-Ventricle Physiology
- Chapter 26 Stage I Palliation, Hypoplastic Left Heart Syndrome
- Chapter 27 Bidirectional Glenn
- Chapter 28 Lateral Tunnel Fenestrated Fontan
- Chapter 29 Extracardiac Fontan
- Chapter 30 Failing Fontan
- Section 6 Heart Failure, Mechanical Circulatory Support, and Transplantation
- Section 7 Miscellaneous Lesions and Syndromes
- Index
- References
Chapter 28 - Lateral Tunnel Fenestrated Fontan
from Section 5 - Single-Ventricle Physiology
Published online by Cambridge University Press: 09 September 2021
- Congenital Cardiac Anesthesia
- Congenital Cardiac Anesthesia
- Copyright page
- Dedication
- Contents
- Contributors
- Introduction
- Chapter 1 A Congenital Heart Disease Primer
- Section 1 Left-to-Right Shunts
- Section 2 Right-Sided Obstructive Lesions
- Section 3 Left-Sided Obstructive Lesions
- Section 4 Complex Mixing Lesions
- Section 5 Single-Ventricle Physiology
- Chapter 26 Stage I Palliation, Hypoplastic Left Heart Syndrome
- Chapter 27 Bidirectional Glenn
- Chapter 28 Lateral Tunnel Fenestrated Fontan
- Chapter 29 Extracardiac Fontan
- Chapter 30 Failing Fontan
- Section 6 Heart Failure, Mechanical Circulatory Support, and Transplantation
- Section 7 Miscellaneous Lesions and Syndromes
- Index
- References
Summary
The Fontan operation is the final stage of single-ventricle palliation that effectively separates the pulmonary and systemic circulations. The procedure connects the inferior vena cava directly to the pulmonary arteries or to the previously created superior cavopulmonary anastomosis, which allows all of the deoxygenated systemic venous return to flow directly to the lungs. The single ventricle then pumps oxygenated pulmonary venous blood to the systemic circulation. Baseline higher central venous pressure drives the Fontan circulation. There is an increased incidence of severe spinal deformities in children with congenital heart disease that will require corrective surgery, including posterior spinal fusion. Anesthesia for posterior spinal fusion in Fontan patients presents significant challenges, especially as the patient is in the prone position, which further exacerbates hemodynamic instability. This chapter discusses the perioperative management of a Fontan patient for posterior spinal fusion.
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- Congenital Cardiac AnesthesiaA Case-based Approach, pp. 207 - 216Publisher: Cambridge University PressPrint publication year: 2021