Anaesthetic Management in a Patient with Fontan Circulation Posted for Elective Tibial Nailing

The fatality rate for pediatric population with complex congenital cardiac disease has decreased as a result of improvements in surgical techniques and conservative management [1]. Therefore, more patients are presenting non-cardiac surgeries adults history [2]. For individuals single ventricle physiology, the fontan procedure is palliative operation that reroutes systemic venous return to pulmonary artery [3]. Despite outcomes, this aberrant circulation number co-morbidities, including dysfunction, arrhythmias, shunt abnormalities, limited exercise ability, other manifestations [4]. These raise various anaesthetic concerns, such understanding underlying morphology mechanics being conversant complexities physiology efficient intra-operative management. In report, we present case 17-year-old male, heart posted electively left tibia nailing under sequential combined spinal epidural anaesthesia.