Anaesthetic Management of One-Lung Ventilation in a Fontan Patient

Patients with Fontan circulation are increasingly presenting for non-cardiac surgical procedures in adulthood, often involving complex anaesthetic management due to their unique physiology. We report the case of a 39-year-old Fontan patient who underwent elective thoracoscopic epicardial pacemaker lead revision under one-lung ventilation, requiring advanced hemodynamic monitoring, inotropic support, and pulmonary vasodilators. This case highlights the significant perioperative challenges in such patients and the need for a specialised, multidisciplinary team. In addition to this case, we reviewed previously published reports on one-lung ventilation in Fontan patients to provide a broader perspective on perioperative strategies and outcomes in this high-risk population.