Anesthesia Management for Percutaneous Lymphatic Embolization in Fontan Patient

Abstract

Protein-losing enteropathy（PLE）and plastic bronchitis（PB）are critical complications after the Fontan procedure and are known risk factors for mortality. Percutaneous lymphatic embolization in 2 patients with PLE and 1 PB patient was performed under general endotracheal anesthesia with positive pressure ventilation. Hemodynamics were carefully monitored by an adequate administration of fluid and Liberal use of catecholamines. The 2 cases with PLE had an uneventful perioperative course, but the PB case experienced an airway emergency due to bronchial obstruction with mucus plugs after induction of anesthesia. In patients with Fontan circulation undergoing noncardiac surgeries, it is crucial to assess preoperative status including Fontan-related complications and design strict anesthetic plans on a case-to-case basis.