Anesthetic management for withdrawal from a right ventricular assist device and Fontan procedure in a patient with an implantable left ventricular assist device for fulminant cardiomyopathy

JA Clinical Reports

Table 2 Fontan circulation management

・TEE	Single ventricle heart function
	Atrioventricular valve regurgitation
	Stenosis of SVC/IVC anastomosis
	Pulmonary artery stenosis
・CVP	Target < 15 mmHg (< 20 mmHg just after surgery)
	Fenestration consideration if CVP is high
	Varies with factors of infusion volume, atrial pressure, and TPG
・Atrial pressure	Target < 10 mmHg (< 15 mmHg just after surgery)
・Atrial pressure	Infusion volume and use of inotropic drugs while checking Lactate and SvO2
・TPG	Target < 10 mmHg
	Prevention of atelectasis
	Appropriate PEEP or single ventilation volume
	Normocapnia

TEE transesophageal echocardiography, SVC superior vena cava, IVC inferior vena cava, CVP central venous pressure, TPG transpulmonary gradient, SvO₂ mixed venous oxygen saturation, PEEP peak end-expiratory pressure