Mishra Gayatri, Nagella Amrutha Bindu, Parthasarathy S, Vivek Bangaru
Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Puducherry, India.
Anesth Essays Res. 2015 Sep-Dec;9(3):408-10. doi: 10.4103/0259-1162.157466.
Here, we report a rare case of a 23-year-old term parturient with Eisenmenger syndrome due to Taussig-Bing anomaly presenting with gestational hypertension, oligohydramnios, and intrauterine growth retardation posted for elective cesarean section. Preoperatively, echocardiography of the patient was suggestive of double-outlet right ventricle (DORV) with large sub-pulmonic ventricular septal defect (VSD), right ventricular hypertrophy, bidirectional shunt and severe pulmonary artery hypertension. The surgery was successfully performed under a graded segmental epidural anesthesia with 2% lignocaine. Further contrast-enhanced computer tomography scan was done postoperatively and a diagnosis of Taussig-Bing anomaly (DORV with sub-pulmonic VSD) with transposition of the great arteries physiology was made. This is one of the rare cases of anesthetic management for cesarean section in a parturient with uncorrected Taussig-Bing anomaly being reported.
在此,我们报告一例罕见病例,一名23岁足月产妇因陶西格-宾氏畸形患有艾森曼格综合征,出现妊娠高血压、羊水过少和胎儿宫内生长受限,拟行择期剖宫产。术前,患者的超声心动图提示右心室双出口(DORV),伴有大型肺下型室间隔缺损(VSD)、右心室肥厚、双向分流和重度肺动脉高压。手术在2%利多卡因的分级硬膜外麻醉下成功进行。术后进一步进行了对比增强计算机断层扫描,诊断为具有大动脉转位生理特征的陶西格-宾氏畸形(右心室双出口伴肺下型室间隔缺损)。这是报道的未矫正陶西格-宾氏畸形产妇剖宫产麻醉管理的罕见病例之一。