An Adult Patient with Fontan Physiology: A TEE Perspective
Fontan and Baudet described in 1971 the separation of the pulmonary and systemic circulations resulting in univentricular physiology. The evolution of the Fontan procedure, most notably the substitution of right atrial-to-pulmonary artery anastomosis with cavopulmonary connections, resulted in signi...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/475015 |
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| author | Edward Gologorsky Angela Gologorsky Eliot Rosenkranz |
| author_facet | Edward Gologorsky Angela Gologorsky Eliot Rosenkranz |
| author_sort | Edward Gologorsky |
| collection | DOAJ |
| description | Fontan and Baudet described in 1971 the separation of the pulmonary and systemic circulations resulting in univentricular physiology. The evolution of the Fontan procedure, most notably the substitution of right atrial-to-pulmonary artery anastomosis with cavopulmonary connections, resulted in significantly improved late outcomes. Many patients survive well into adulthood and are able to lead productive lives. While ideally under medical care at specialized centers for adult congenital cardiac pathology, these patients may present to the outside hospitals for emergency surgery, electrophysiologic interventions, and pregnancy. This presentation presents a “train of thought,” linking the TEE images to the perioperative physiologic considerations faced by an anesthesiologist caring for a patient with Fontan circulation in the perioperative settings. Relevant effects of mechanical ventilation on pulmonary vascular resistance, pulmonary blood flow and cardiac preload, presence of coagulopathy and thromboembolic potential, danger of abrupt changes of systemic vascular resistance and systemic venous return are discussed. |
| format | Article |
| id | doaj-art-4f65ea5ec3504d70a78f420c572fa85f |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-4f65ea5ec3504d70a78f420c572fa85f2025-02-03T01:01:07ZengWileyAnesthesiology Research and Practice1687-69621687-69702012-01-01201210.1155/2012/475015475015An Adult Patient with Fontan Physiology: A TEE PerspectiveEdward Gologorsky0Angela Gologorsky1Eliot Rosenkranz2Anesthesiology, Miller School of Medicine, Jackson Memorial Hospital, University of Miami, Miami, FL 33136, USAAnesthesiology, Memorial Regional Hospital East, Hollywood, FL 33136, USADivision of Cardiothoracic Surgery, Miller School of Medicine, Jackson Memorial Hospital, University of Miami, FL 33136, USAFontan and Baudet described in 1971 the separation of the pulmonary and systemic circulations resulting in univentricular physiology. The evolution of the Fontan procedure, most notably the substitution of right atrial-to-pulmonary artery anastomosis with cavopulmonary connections, resulted in significantly improved late outcomes. Many patients survive well into adulthood and are able to lead productive lives. While ideally under medical care at specialized centers for adult congenital cardiac pathology, these patients may present to the outside hospitals for emergency surgery, electrophysiologic interventions, and pregnancy. This presentation presents a “train of thought,” linking the TEE images to the perioperative physiologic considerations faced by an anesthesiologist caring for a patient with Fontan circulation in the perioperative settings. Relevant effects of mechanical ventilation on pulmonary vascular resistance, pulmonary blood flow and cardiac preload, presence of coagulopathy and thromboembolic potential, danger of abrupt changes of systemic vascular resistance and systemic venous return are discussed.http://dx.doi.org/10.1155/2012/475015 |
| spellingShingle | Edward Gologorsky Angela Gologorsky Eliot Rosenkranz An Adult Patient with Fontan Physiology: A TEE Perspective Anesthesiology Research and Practice |
| title | An Adult Patient with Fontan Physiology: A TEE Perspective |
| title_full | An Adult Patient with Fontan Physiology: A TEE Perspective |
| title_fullStr | An Adult Patient with Fontan Physiology: A TEE Perspective |
| title_full_unstemmed | An Adult Patient with Fontan Physiology: A TEE Perspective |
| title_short | An Adult Patient with Fontan Physiology: A TEE Perspective |
| title_sort | adult patient with fontan physiology a tee perspective |
| url | http://dx.doi.org/10.1155/2012/475015 |
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