We present the case of a 26 year old polytrauma patient with a left intra-articular distal radial fracture, with an uncorrected late univentricular heart with severe pulmonary hypertension, subsequent Eisenmenger syndrome and supraventricular tachycardia managed with metoprolol.We find this case particularly interesting given the need for osteosynthesis with the obstacle of a non-palliated congenital heart disease in an adult; whose anesthetic implications required considerations to avoid fatal outcomes in the perioperative setting.Ultimately the patient underwent regional anesthesia with careful hemodynamics monitoring, leading to a satisfactory outcome.