Physiopathological Approach of the Fontan Patient for Noncardiac Surgery for the Anesthesiologist

Abstract

Since 1971, when Dr. Francis Fontan and collaborators described a surgical technique that restored pulmonary flow in patients with tricuspid atresia and despite the fact that it has had modifications over time, the impact on the survival of these patients has been notable. It is currently known as the Fontan procedure and is indicated to treat single ventricle congenital heart defects. Thanks to the great advances in the field of congenital heart surgery, as well as better pediatric cardiology and intensive care management, the survival of patients with congenital heart defects has increased significantly, among whom are patients with univentricular or single ventricle physiology. The objective of this chapter is to provide the anesthesiologist with useful and applicable concepts in the evaluation and perioperative management of patients with a Fontan repair, especially for noncardiac surgeries.