Anaesthetic Management of a Patient with Fontan Circulation for Laparoscopic Cholecystectomy

  • Bashu Dev Parajuli Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
  • Allen Suwal Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
  • Amit Sharma Bhattrai Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
  • Basanta Ghimire Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
  • Pankaj Joshi Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
  • Megha Koirala Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
  • Prasan Bir Singh Kansakar Department of General Surgery,Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu
DOI: https://doi.org/10.33314/jnhrc.v20i3.3745

Abstract

Fontan circulation is a complex surgical procedure carried out in infants in a staged fashion, where caval circulation is connected to the pulmonary circulation, bypassing the heart. The ventricular activity will drive the blood to pulmonary circulation, which, after oxygenation, will return to heart and then will distribute through-out the body. The pulmonary vascular resistance determines the preload, which further depends upon the volume status of the body. This physiology is further complicated by the presence of arrythmia, liver cirrhosis, caval-pulmonary shunt thrombosis and low ventricular activity. Anaesthetic implication of such case includes challenges to manage preload, maintenance of pulmonary vascular resistance, preservation of the single ventricular function and avoidance of circuit thrombosis. Here we present a case of 15 years female who presented to our centre for laparoscopic cholecystectomy.
Keywords: Cholecystectomy; Circulation; Laparoscopic.

Published
2023-03-10
How to Cite
ParajuliB. D., SuwalA., Sharma BhattraiA., Ghimire B., JoshiP., KoiralaM., & Singh KansakarP. B. (2023). Anaesthetic Management of a Patient with Fontan Circulation for Laparoscopic Cholecystectomy. Journal of Nepal Health Research Council, 20(3), 801-803. https://doi.org/10.33314/jnhrc.v20i3.3745
Issue
Vol. 20 No. 3 (2022): Issue 56 july-Sep, 2022
Section
Case Report

Copyright (c) 2023 Bashu Dev Parajuli, Allen Suwal, Amit Sharma Bhattrai, Basanta Ghimire, Pankaj Joshi, Megha Koirala, Prasan Bir Singh Kansakar

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