A case series of different anesthesia approaches for single ventricular physiology patients in various stages of palliation underwent noncardiac procedures

• Published in: Saudi journal of anaesthesia Vol. 12; no. 4; pp. 629 - 633
• Main Authors: Alatassi, Abdulaleem, Mulero, Silvia, Massoud, Nancy, Alzayer, Zainab, Mahmoud, Ahmed
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.10.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Age; Anesthesia; Anesthesia of noncardiac surgery; congenital heart disease; Fontan procedure; Glenn circulation; intraoperative complications; postoperative complications; risk factors; single ventricle physiology; Case Report; Child health; Children & youth; Congenital diseases; Congenital heart defects; Consent; Genetic disorders; Heart; Hospitals; Intensive care; Intubation; Medical personnel; Patients; Pediatrics; Physiological aspects; Physiology; Pulmonary arteries; Rehabilitation; Studies; Surgery; Veins & arteries; intraoperative complications; Glenn circulation; risk factors; single ventricle physiology; Fontan procedure; congenital heart disease; postoperative complications; Anesthesia of noncardiac surgery
• ISSN: 1658-354X; 0975-3125
• DOI: 10.4103/sja.SJA_36_18

Patients with single ventricle physiology (SVP) are a particularly challenging population with congenital heart disease (CHD); they will go for staged, palliation ending in the Fontan circulation. Nowadays, with improvement in surgical procedures for CHD, these patients become growing population, and noncardiac surgeries become not uncommon. The authors report different anesthesia approaches for four pediatric patients with SVP underwent ten noncardiac procedures done under general anesthesia following the different stages of palliation at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, between 2009 and 2015 and do a brief review of the literature on this topic. The aim of this study is to highlight that anesthesia approach for patients with SVP varies according to the patient physical situation at the time of the procedure, stage of palliation, and type of surgery. Therefore, every anesthesiologist should have thorough knowledge about SVP, different stages of palliative surgery, anesthesia concern in each one and risk factors associated with perioperative morbidity before anesthetizing patients for a noncardiac procedure to keep patient safety as well as avoiding unnecessary cancellation, rescheduling, and admissions to the ward or the Intensive Care Unit.