Abstract
Background Noncardiac surgery for adult congenital heart disease patients with Fontan circulation is increasing. Special care must be taken to maintain pulmonary circulation. Pneumonectomy is a particularly challenging procedure for pulmonary circulation because of the intraoperative one-lung ventilation (OLV) and lung resection. In this report, we describe the successful management of a partial pulmonary resection under general anesthesia with remimazolam. Case presentation A 39-year-old woman presented with a right ventricular single ventricle Fontan circulation. A laparoscopic partial pulmonary resection was planned. Remimazolam was used for general anesthesia, stable circulation was obtained with dobutamine and noradrenaline, and postoperative spontaneous respiration was quickly obtained with antagonism by flumazenil and managed with stable respiratory and circulatory dynamics. Conclusion General anesthesia with remimazolam could be one of the options for noncardiac surgery in the Fontan circulation because of its lower circulatory depression and rapid recovery of spontaneous breathing by antagonist.
