Benefit of transesophageal echocardiography monitoring during cesarean section in a patient with complete atrioventricular canal defect

Anesthesia is a challenge in patients with congenital heart disease, especially during pregnancy and surgical delivery. A 23-year-old with a 34-week gestation, primigravida with atrioventricular (AV) canal defect was scheduled for a cesarean section. Preoperative transthoracic echocardiography (TTE)...

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Published inJournal of obstetric anaesthesia and critical care Vol. 6; no. 1; pp. 25 - 27
Main Authors Gill, Amarpreet, Garg, Dinesh, Arya, Rajesh, Katyal, Sunil, Gill, Gurpreet, Juneja, Sunil
Format Journal Article
LanguageEnglish
Published Wolters Kluwer - Medknow Publications 01.01.2016
Medknow Publications and Media Pvt. Ltd
Wolters Kluwer Medknow Publications
Subjects
Atrioventricular (AV) canal defect
Cardiac patients
cesarean section
Echocardiography
general anesthesia
Genetic disorders
lower segment cesarean section (LSCS)
transesophageal echocardiography (TEE)
cesarean section
transesophageal echocardiography (TEE)
general anesthesia
lower segment cesarean section (LSCS)
Atrioventricular (AV) canal defect
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Summary:Anesthesia is a challenge in patients with congenital heart disease, especially during pregnancy and surgical delivery. A 23-year-old with a 34-week gestation, primigravida with atrioventricular (AV) canal defect was scheduled for a cesarean section. Preoperative transthoracic echocardiography (TTE) revealed a complete AV canal defect (Rastelli type II) with left-to-right shunt. Ventricular functions were normal. The patient was administered general anesthesia with endotracheal intubation, and a transesophageal echocardiography (TEE) probe was placed to monitor cardiac functions. The volume status of the parturient and the shunt fraction were continuously monitored with the echocardiography probe during the surgery. Minimal shunting at ventricular septal defect (VSD) was observed, as it was covered by the AV valve leaflets. The patient tolerated the procedure well and the trachea was extubated once she fulfilled the extubation criteria. Intraoperative TEE monitoring was a useful tool to understand and manage hemodynamic variations during cesarean section in the parturient with a complex cardiac lesion.
ISSN:2249-4472
DOI:10.4103/2249-4472.181070