Anesthetic management of a single-ventricle pediatric patient with scoliosis: A case report

Abstract

Single ventricle is a complex cardiac disease which carry high morbidity and mortality and the average 3 years survival rate without Fontan procedure was approximated to be 75%. The most common etiologies are: hypoplastic left heart syndrome and tricuspid atresia. When those patient plan to go for surgery, it’s very essential for anesthetist to understand how the physiology is affected rather than etiology. BT shunt patency, right ventricular function and pulmonary artery pressure should be evaluated before any procedure under anesthesia. Scoliosis corrective surgery is a procedure that has its special considerations related to restrictive pulmonary disease, prone positioning, and major bleeding that may occur, which altogether will add to the risk when being conducted in a single-ventricle patient and will necessitate vigilance and special care during monitoring intraoperatively. Here, we report a simple way to monitor the transpulmonary pressure gradient through two central lines in the femoral and jugular veins as part of the patient’s anesthesia management.