Anesthetic Management of a Patient With a Single Ventricle and Fontan Circulation Presenting for an Emergency Cesarean Birth
Samhati Mondala✉, Savannah Cofera✉, Michael Brusha✉, Shobana Bharadwaja✉, Earl Wilsona✉, John G. Augoustidesb✉, Liliane R. Ernstc✉, Rohesh J. Fernandod✉, Afif M. Kraiteme✉, Marie‐Louise Menge✉
- aDepartment of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD
- bCardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- cDepartment of Anesthesiology, Division of Obstetric Anesthesiology and Cardiothoracic Anesthesiology, Wake Forest University School of Medicine, Winston Salem, NC
- dDepartment of Anesthesiology, Division of Cardiothoracic Anesthesiology, Wake Forest University School of Medicine, Winston Salem, NC. Electronic address: rohesh.fernando@wfusm.edu
- eDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
- ✉Corresponding author
Papers open inside SciRah from the original publisher or repository; SciRah never hosts them.
Abstract
The incidence of single ventricle physiology is up to 3% among all congenital heart diseases.1 The term ‘single ventricle’ includes a wide variety of congenital heart diseases, including ventricular connections, common ventricle, etc., which all share a common feature of having a single functional ventricle.1-3 Fontan is a common procedure that is used in patients with single ventricles to separate systemic and pulmonary circulations.4 In the absence of a subpulmonic pumping ventricle, pulmonary circulation is highly preload dependent and hemodynamic decompensation can be rapid in the setting of increased demand for cardiac output.

