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Safe management of cesarean section in a patient of Eisenmenger syndrome


1 Division of Anesthesia, Mauriziano Umberto I Hospital, Turin, Italy
2 Division of Gynaecology, University of Turin, Mauriziano Umberto I Hospital, Turin, Italy
3 Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy

Correspondence Address:
Fabrizio Sansone
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Largo Turati 62, 10135, Turin
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.101863

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Year : 2012  |  Volume : 15  |  Issue : 4  |  Page : 296-298

 

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We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO) (as a bridge to recovery or bridge to salvage) was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.






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1 Division of Anesthesia, Mauriziano Umberto I Hospital, Turin, Italy
2 Division of Gynaecology, University of Turin, Mauriziano Umberto I Hospital, Turin, Italy
3 Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy

Correspondence Address:
Fabrizio Sansone
Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Largo Turati 62, 10135, Turin
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.101863

Rights and Permissions

We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO) (as a bridge to recovery or bridge to salvage) was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.






[FULL TEXT] [PDF]*


        
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