[Patient with a Fontan circulation undergoing caesarean section: Anesthesiological management]

Area of Science:

• Anesthesiology
• Cardiology
• Obstetrics

Background:

• Adult congenital heart disease (CHD) management presents unique anesthetic challenges.
• Improved treatments increase life expectancy, leading to a growing population of adults with CHD, including pregnant individuals.
• Fontan circulation requires specialized anesthetic strategies due to its complex pathophysiology.

Observation:

• A case report details the anesthetic management of a pregnant patient with Fontan circulation.
• The patient also had aortic coarctation, adding complexity to the clinical scenario.
• Atonic uterine hemorrhage complicated the postpartum period.

Findings:

• Successful anesthetic management principles for pregnant patients with Fontan circulation were applied.
• The case illustrates the importance of multidisciplinary care in managing complex CHD during pregnancy.
• Prompt recognition and management of postpartum hemorrhage were critical.

Implications:

• This case provides valuable insights for anesthesiologists managing pregnant patients with complex CHD.
• It underscores the need for tailored anesthetic plans considering Fontan physiology and potential complications.
• Enhanced understanding can improve maternal and fetal outcomes in this high-risk population.