Outcomes of general anesthesia for noncardiac surgery in a series of patients with Fontan palliation

Jennifer A. Rabbitts, Cornelius B. Groenewald, William J. Mauermann, David W. Barbara, Harold M. Burkhart, Carole A. Warnes, William C. Oliver, Randall P. Flick

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Objectives To describe the experience of a single, tertiary care institution in the care of patients with Fontan physiology undergoing anesthesia for noncardiac surgery. Background The Fontan procedure was developed in 1971 to palliate patients with univentricular cardiac physiology leading to long-term survival of these patients, who may now present as adults for noncardiac surgery. Methods We retrospectively reviewed the medical records of Fontan patients 16 years and older who underwent general anesthesia for noncardiac surgery at Mayo Clinic in Rochester, Minnesota. Preoperative data, perioperative course, intraoperative and postoperative hemodynamic, pulmonary, cardiovascular, and renal complications were described. Results Thirty-nine general anesthetics were administered to 31 patients for noncardiac surgery after Fontan palliation. Perioperative complications occurred in 12 of the 39 (31%) noncardiac surgeries, and there was one postoperative death that occurred on day 13 after ventral hernia repair. The two patients who had complications that did not resolve (long-term dialysis and death) had ejection fractions well below the mean for the group (22% and 28%). Conclusion It may be more appropriate for Fontan patients to undergo anesthesia for noncardiac surgery in a tertiary institution, particularly patients with an ejection fraction of <30%. Intraoperative arterial blood pressure monitoring and overnight admission are likely appropriate for most cases.

Original languageEnglish (US)
Pages (from-to)180-187
Number of pages8
JournalPaediatric Anaesthesia
Volume23
Issue number2
DOIs
StatePublished - Feb 2013

Keywords

  • congenital heart disease
  • single ventricle
  • univentricular

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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