Anaesthetic Management of Congenital Cyanotic Heart Disease in a Robotic-Assisted Pheochromocytoma Excision: A Rare Case Study of Preload-Dependent Physiology

Background and Case: This case study examines the Anaesthesia management of a 22-year-old female with congenital cyanotic heart disease (CCHD) and a hyper-vascular adrenal lesion suggestive of pheochromocytoma, who underwent robotic-assisted surgery. The patient’s complex history , mixing lesion including single ventricle physiology with and reduced pulmonary blood flow, presented significant perioperative challenges such as avoiding hyperoxemia ,hypercarbia , avoiding hemodynamic pertubations, which may increase risk of overflow in shunt and thrombosis. Conclusion: An effective Anaesthetic approach was crucial, involving a multidisciplinary team to ensure hemodynamic stability and address the unique risks associated with robotic techniques. Strategies included meticulous fluid management, tailored medication regimens for blood pressure control, and advanced monitoring throughout the procedure. Postoperatively, vigilant management of analgesia and fluid was essential to prevent post operative pulmonary complications Keywords: Anaesthesia, Congenital Heart Disease, Pheochromocytoma, Perioperative Management, Robotic Surgery, Metanephrines