Liver tumor resection in a patient with Fontan circulation and monitoring with a Pulse Contour Cardiac Output catheter

Abstract

　With the increasing number of adult congenital heart disease patients, noncardiac surgeries in this group are expected to increase. We performed general anesthesia during resection of a liver tumor in an adult patient with Fontan circulation. In addition to continuous invasive monitoring of arterial and pulmonary arterial pressure, we also used values measured with a Pulse Contour Cardiac Output (PiCCO) catheter as indicators of circulation. In this patient, there were concerns that Fontan circulation would fail due to positive-pressure ventilation using an artificial respirator and blocking of portal veins during the surgical procedure. The PiCCO catheter was useful for managing circulation.