One-lung ventilation in a patient with Fontan circulation undergoing diaphragmatic plication surgery: a case report

被引：0
作者：
Sasaki, Yusuke [1 ]
Kato, Jungo [1 ]
Minoshima, Rie [1 ]
Nagata, Hiromasa [1 ]
Minamishima, Shizuka [1 ]
Suzuki, Takeshi [1 ]
Morisaki, Hiroshi [1 ]
机构：
[1] Keio Univ, Sch Med, Dept Anesthesiol, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan
来源：
JA CLINICAL REPORTS | 2019年 / 5卷 / 01期
关键词：
One lung ventilation; Fontan circulation; Hypoxic pulmonary vasoconstriction; Pulmonary angiography; Hemidiaphragmatic paralysis; MANAGEMENT; PARALYSIS; TERM;
D O I：
10.1186/s40981-019-0270-x
中图分类号：
R614 [麻醉学];
学科分类号：
100217 ;
摘要：
Background: Surgeries requiring one-lung ventilation (OLV) in patients with Fontan circulation pose great challenges. However, little information is available regarding the safety of OLV in Fontan patients when hemidiaphragmatic paralysis is present. Case presentation: A 41-year-old woman who underwent repeated Fontan procedures was re-admitted to our hospital because of worsening shortness of breath. As left hemidiaphragmatic paralysis was considered to be contributing to her symptom, an open thoracic left diaphragmatic plication surgery was scheduled. A preoperative pulmonary artery angiogram revealed a remarkably reduced blood flow to the left lung. The surgeon requested OLV during the surgery. Despite our concern regarding the impact of OLV on the Fontan circulation, OLV did not result in major hemodynamic changes. Conclusion: OLV can be safely implemented in patients with hemidiaphragmatic paralysis with preserved Fontan circulation. Preoperative pulmonary artery angiography may provide useful information for estimating the impact of OLV on the Fontan circulation.
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页数：5
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