Kelly J Zach1, Harish Ramakrishna1, Krishnashwamy Chandrasekaran2, Ricardo A Weis1
1 Department of Anesthesia, Division of Cardiothoracic Anethesia, Mayo Clinic Hospital, Phoenix, AZ, USA
2 Department of Cardiology, Mayo Clinic Hospital, Phoenix, AZ, USA
Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes.
Dr. Kelly J Zach
5777 E Mayo Blvd., Phoenix, AZ 85054
Source of Support: None, Conflict of Interest: None
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