Anesthetic management of labor and postpartum bleeding in a patient with Fontan physiology

We describe the obstetric anesthetic management of a patient with complex congenital heart anomaly consisting of transposed great arteries, double inlet left ventricle and subpulmonic stenosis. Successful management of a patient with Fontan physiology mandates a thorough understanding of the hemodyn...

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Bibliographic Details
Published inIsrael journal of medical sciences Vol. 33; no. 11; p. 749
Main Authors Grunwald, Z, Friedman, L, Hirsch, R, Doron, K
Format Journal Article
LanguageEnglish
Published Israel 01.11.1997
Subjects
Adult
Anesthesia, Obstetrical - methods
Female
Fontan Procedure
Heart Defects, Congenital - physiopathology
Heart Defects, Congenital - surgery
Humans
Labor, Obstetric
Postpartum Hemorrhage - physiopathology
Postpartum Hemorrhage - therapy
Pregnancy
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Summary:We describe the obstetric anesthetic management of a patient with complex congenital heart anomaly consisting of transposed great arteries, double inlet left ventricle and subpulmonic stenosis. Successful management of a patient with Fontan physiology mandates a thorough understanding of the hemodynamic consequences of this procedure and the alterations during pregnancy. The major considerations are related to the fact that the systemic venous return reaches the pulmonary vasculature without the augmentation of a functioning ventricle.
ISSN:0021-2180