Abstract
BackgroundSurgeries 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 presentationA 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.ConclusionOLV 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.
Highlights
Surgeries requiring one-lung ventilation (OLV) in patients with Fontan circulation pose great challenges
OLV can be safely implemented in patients with hemidiaphragmatic paralysis with preserved Fontan circulation
Little information is available regarding the safety of OLV in Fontan patients when hemidiaphragmatic paralysis is present
Summary
OLV can be safely implemented in patients with hemidiaphragmatic paralysis with preserved Fontan circulation.
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