Abstract:
A 30-year-old woman with corrected transposition of great arteries (c-TGA) was scheduled for elective cesarean section at 37 weeks of gestation. At previous cesarean section, she received general anesthesia for dyspnea and lower cardiac function by severe mitral regurgitation, with a pulmonary catheter inserted. In the current pregnancy, she had tricuspid regurgitation, but she had no signs of heart failure. Cardiac index (CI) and stroke volume variation (SVV) were monitored by the FloTrack, before induction of anesthesia. Because the CI was 3.6 l x min(-1) x m(-2), and the SVV was 18%, we decided to perform combined spinal epidural anesthesia. Epidural anesthesia was performed at L1-2, and spinal anesthesia was performed at L3-4. Hyperbaric 0.5% bupivacaine 2.0 ml with fentanyl 10 μg was given to the subarachnoid space. The total dose of phenylephrine administered was 150 μg, and the CI as well as the SVV were stable during surgery. Her postpartum couse was uneventful. Anesthetic management of c-TGA is discussed, and we should select anesthetic method carefully.
Hashimoto, Sato, Sasaki, Arai, Yoshida, Okuda, , , (2015). [Anesthetic Management of a Patient with Corrected Transposition of Great Arteries for Cesarean Section]. Masui. The Japanese journal of anesthesiology, 2015 Feb;64(2):157-9. https://www.ncbi.nlm.nih.gov/pubmed/26121808