Perioperative Considerations for the Fontan Patient Requiring Noncardiac Surgery

Adam C Adler; Aruna T Nathan

doi:10.1016/j.anclin.2020.04.001

Perioperative Considerations for the Fontan Patient Requiring Noncardiac Surgery

Anesthesiol Clin. 2020 Sep;38(3):531-543. doi: 10.1016/j.anclin.2020.04.001. Epub 2020 Jul 16.

Authors

Adam C Adler¹, Aruna T Nathan²

Affiliations

¹ Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin Street, Houston, TX 77030, USA. Electronic address: adamcadler@gmail.com.
² Department of Anesthesia, Stanford University Medical Center, 300 Pasteur Drive, Room H3580, MC 5640, Stanford, CA 94304, USA.

PMID: 32792182
DOI: 10.1016/j.anclin.2020.04.001

Abstract

Children and adults with congenital heart disease undergoing noncardiac surgery are at higher risk of perioperative adverse events. Patients have significant comorbidities and syndromic associations that increase perioperative risk further. The complexity of congenital heart disease requires a thorough understanding of lesion-specific pathophysiology in order to provide safe care. Comprehensive multidisciplinary planning and the use of skilled and experienced teams achieve the best outcomes. The anesthesiologist is a perioperative physician charged with providing safe anesthesia care, instituting appropriate hemodynamic monitoring, and determining appropriate postoperative disposition on an individual basis.

Keywords: Congenital heart disease; Fontan; Noncardiac surgery; Pediatric anesthesiology; Pediatrics; Risk assessment.

Publication types

Review

MeSH terms

Anesthesiology / methods*
Child
Fontan Procedure*
Heart Defects, Congenital / surgery*
Humans
Perioperative Care / methods*
Surgical Procedures, Operative / methods*