Anaesthetic Management of One-Lung Ventilation in a Fontan Patient

Coulie, Richard;Ryckaert, Francis;Raevsky, Evgeny;Tsang, Victor;Wright, Susan
(2025) Cureus — Vol. 17, n° 8, p. e89274 (2025)

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Authors
  • Coulie, RichardUCLouvain
    Author
  • Ryckaert, Francis
    Author
  • Raevsky, Evgeny
    Author
  • Tsang, Victor
    Author
  • Wright, Susan
    Author
Abstract
Patients with Fontan circulation are increasingly presenting for non-cardiac surgical procedures in adulthood, often involving complex anaesthetic management due to their unique physiology. We report the case of a 39-year-old Fontan patient who underwent elective thoracoscopic epicardial pacemaker lead revision under one-lung ventilation, requiring advanced hemodynamic monitoring, inotropic support, and pulmonary vasodilators. This case highlights the significant perioperative challenges in such patients and the need for a specialised, multidisciplinary team. In addition to this case, we reviewed previously published reports on one-lung ventilation in Fontan patients to provide a broader perspective on perioperative strategies and outcomes in this high-risk population.
Affiliations
  • Barts Health NHS TrustDepartment of Perioperative Medicine, Bart's Heart Centre

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Coulie, R., Ryckaert, F., Raevsky, E., Tsang, V., & Wright, S. (2025). Anaesthetic Management of One-Lung Ventilation in a Fontan Patient. Cureus, 17(8), e89274. https://doi.org/10.7759/cureus.89274 (Original work published 2025)