Safe management of cesarean section in a patient of Eisenmenger syndrome.

Abstract

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.

• Authors: Silvia Minicucci, Vincenzo Segala, Claudio Verdecchia, Piero Sismondi, Riccardo Casabona, Fabrizio Sansone
• Journal: Annals of cardiac anaesthesia (Ann Card Anaesth) 2012 Oct-Dec Vol. 15 Issue 4 Pg. 296-8 ISSN: 0974-5181 [Electronic] India
• PMID: 23041687 (Publication Type: Case Reports, Journal Article)

Topics

• Cesarean Section
• Eisenmenger Complex (physiopathology)
• Extracorporeal Membrane Oxygenation
• Familial Primary Pulmonary Hypertension
• Female
• Humans
• Hypertension, Pulmonary (etiology)
• Pregnancy
• Pregnancy Complications, Cardiovascular (physiopathology)