Management of 1-Lung Ventilation in a Patient With Failing Fontan Circulation.

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.

Duke Scholars

Author Yasmin Maisonave Anesthesiology, Cardiothoracic

Author Madhav Swaminathan Anesthesiology, Cardiothoracic