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Laparoscopic cholecystectomy in a patient with Fontan circulation
Rattanaporn Tankul1,2, Becky Rodrigues3, Laura V Duggan3
1Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. rattanaporn.tan@mahidol.ac.th.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 18, 2024
Summary
Laparoscopic surgery in patients with Fontan circulation requires careful hemodynamic monitoring. Transesophageal echocardiography and inhaled milrinone can effectively manage challenges like decreased pulmonary blood flow during the procedure.
Area of Science:
- Cardiology
- Surgical Anesthesiology
- Medical Device Technology
Background:
- Fontan circulation physiology presents unique hemodynamic challenges during laparoscopic surgery.
- Carbon dioxide insufflation, positive pressure ventilation, and patient positioning can compromise circulation.
- Patients with Fontan physiology often have complex cardiac histories, including pacemaker dependency.
