Perioperative Management of an Adolescent Fontan Patient with Narrowing of the Aortopulmonary Space for Posterior Scoliosis Surgery

Semin Cardiothorac Vasc Anesth. 2022 Sep;26(3):221-225. doi: 10.1177/10892532221114285. Epub 2022 Aug 11.

Abstract

Congenital cardiac patients who received neonatal reconstructive aortic arch surgery are at risk of aortopulmonary space narrowing with compression of the left pulmonary artery and left main bronchus (LMB) later in life. We discuss a challenging adolescent single ventricle patient who presented for surgical treatment of a non-idiopathic thoracic scoliosis (posterior spinal fusion) with severe stenosis of the LMB and left pulmonary artery due to a narrow aortopulmonary space. Careful preoperative imaging, evaluation, and decision making resulted in successful surgical treatment and uneventful perioperative course.

Keywords: ACHD; Fontan; GUCH; adult congenital heart disease; airway Malacia; aortapulmonary space; cardiac anesthesia; congenital heart disease; non-cardiac surgery; single ventricle.

MeSH terms

  • Adolescent
  • Fontan Procedure* / methods
  • Heart Defects, Congenital* / surgery
  • Humans
  • Infant, Newborn
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / surgery
  • Retrospective Studies
  • Scoliosis* / complications
  • Scoliosis* / surgery
  • Spinal Fusion* / methods
  • Treatment Outcome