Fontan Fenestration Closure Prior to Posterior Spinal Fusion in Patients With Single-Ventricle Heart Disease

Schwartz, Matthew C.; Nykanen, David; Fleishman, Craig E.; Munro, Hamish M.; Phillips, Jonathan; Knapp, Raymond; Felix, Donald E.

doi:10.1097/brs.0000000000001630

Cited by 2 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Severe LMB compression with air trapping in a single ventricle patient who is completely dependent on passive lung flow was considered a major risk during spine surgery. [1][2][3][4] Prone position and positive pressure ventilation will reduce venous return to the heart in a healthy non-cardiac patient, 5 and will profoundly decrease gradient-driven pulmonary blood flow in Fontan physiology. [6][7][8] In this patient, that could be exacerbated by atelectasis, air entrapment, and tension pneumothorax on the left side due to LMB compression.…”

Section: Clinical Challengementioning

confidence: 99%

Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery

Loon

Minkhorst

Heide

et al. 2022

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

Congenital cardiac patients who received neonatal reconstructive aortic arch surgery are at risk of aortopulmonary space narrowing with compression of the left pulmonary artery and left main bronchus (LMB) later in life. We discuss a challenging adolescent single ventricle patient who presented for surgical treatment of a non-idiopathic thoracic scoliosis (posterior spinal fusion) with severe stenosis of the LMB and left pulmonary artery due to a narrow aortopulmonary space. Careful preoperative imaging, evaluation, and decision making resulted in successful surgical treatment and uneventful perioperative course.

show abstract

Section: Clinical Challengementioning

confidence: 99%

Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery

Loon

Minkhorst

Heide

et al. 2022

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

show abstract

“…The major determinant of Fontan outcome is the development of pulmonary hypertension determined by the increasing of pulmonary vessels resistance, in which case the Fontan could derive in a shock state and probably in death [3]. Patients with Fontan circulation could have right to left shunting via a patent Fontan fenestration that can increase the risk of paradoxical systemic embolization, situation much increased in prone position [4].…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management of an Adolescent for Scoliosis Surgery with a Bidirectional Glenn circulation

Dominguez

Burgos

2017

JACCOA

View full text Add to dashboard Cite

The relationship between congenital heart disease and scoliosis is well known. Most of these patients present deformities that can be included in the group on spine deformities associated to a congenital heart disease, and, in another patients, the fact of perform a sternotomy in the first infancy to correct partially the heart defect, predisposes to develop the spine deformity. The improvement of the life expectancy in these patients can increase the probability of being operated of non-cardiac surgery. The patients with single ventricle circulation do not have right ventricle, so that, the pulmonary blood flow depends of the central venous pressure. The prone position used for scoliosis correction could worsen the venous return and the cardiac output. We present a 17 years of female patient case, diagnosed of a kippel Feil syndrome and a complex congenital heart disease (dextrocardia, dextroapex, complete atrioventricular septal defect, double outlet right ventricle, transposition of great arteries, pulmonary stenosis and double inferior vena cava system) partially corrected by Glenn surgery at 2 years. She present a toracolumbar scoliosis that causes severe pulmonary restriction and gets worse her functional class. The patient was operated in prone position by posterior approach and the correction using pedicular screws and bars was developed. Hemodynamic invasive monitoring like Transesophageal echocardiogram (TEE) and continuous arterial pressure monitoring were used; somatosensorial evoked potentials were used too. The patient was carried to the intensive care unit hemodinamically stable. As a severe postoperative complication at the second postoperative day she present superior cava vein thrombosis that was not extended to the pulmonary artery anastomosis and that not compromise the Glenn function. She was anticoagulated with unfractionated heparin being the vein successfully recanalized. 10 days after she was discharged to the hospitalization area.

show abstract

Fontan Fenestration Closure Prior to Posterior Spinal Fusion in Patients With Single-Ventricle Heart Disease

Abstract: N/A.

Cited by 2 publications

References 20 publications

Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery

Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery

Anaesthetic Management of an Adolescent for Scoliosis Surgery with a Bidirectional Glenn circulation

Contact Info

Product

Resources

About