Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management

Kelly J. Zach, Harish Ramakrishna, Krishnashwamy Chandrasekaran, Ricardo A. Weis

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes.

Original languageEnglish (US)
Pages (from-to)252-256
Number of pages5
JournalAnnals of Cardiac Anaesthesia
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2015

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Keywords

  • Anesthesia
  • Blalock-Taussig shunt
  • Congenital heart disease
  • Laparoscopic surgery
  • Single ventricle physiology

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Cardiology and Cardiovascular Medicine

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