Anaesthetic considerations in congenital single ventricle cyanotic heart disease patients undergoing non – cardiac surgery

Congenital heart disease (CHD) is one of the most prevalent congenital disorders, with an incidence rate of 9.1 per 1000 live births. Lesions featuring single ventricle physiology make up about 20% of these cases. This condition involves an abnormal parallel circulation, leading to complications such as ventricular dysfunction, chronic hypoxia, polycythaemia, and infective endocarditis, which collectively increase mortality risk. Patients with a single functioning ventricle have limited tolerance for changes in preload, afterload, myocardial depression, and fluctuations in pulmonary and systemic vascular resistance. Factors like reduced tidal volume, atelectasis, interstitial lung water, and hypoxic pulmonary vasoconstriction contribute to a balanced circulation, but these factors can be significantly altered during induction and intubation. Here, we report the successful management of a male child with single ventricle physiology who underwent an emergency burr hole procedure and tapping of a brain abscess under general anesthesia.