患有严重二叶式主动脉瓣狭窄和充血性心力衰竭的产妇的特殊管理。
Unusual management of parturient patient with severe bicuspid aortic valve stenosis and congestive heart failure.
作者信息
Kahrom Mahdi, Ahmadi Mostafa, Mottahedi Behrooz, Tabari Masoomeh, Vatanchi Atieh, Paravi Naser, Ghaderi Hamid
机构信息
Department of Cardiovascular Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
ARYA Atheroscler. 2018 Jan;14(1):38-40. doi: 10.22122/arya.v14i1.1607.
BACKGROUND
Critical aortic stenosis (AS) is an unusual cardiac pathology in pregnancy, but has significant impact on the fetal and maternal outcomes of pregnancy. Pregnant patients with aortic stenosis and heart failure represent a major challenge for the heart team and anesthesiologist who should balance the risks and benefits of different treatment strategies and their effects on the mother and fetus.
CASE REPORT
We present a 26-year-old parturient who underwent cesarean section at 30 weeks of gestation under general anesthesia in the presence of cardiac surgical team followed by deferred aortic valve replacement after two weeks.
CONCLUSION
This report describes the importance of multidisciplinary preoperative evaluation, and careful surgical and anesthetic planning to avoid the deterioration of perioperative cardiac condition in such patients.
背景
重度主动脉瓣狭窄（AS）在妊娠中是一种不常见的心脏疾病，但对妊娠的胎儿和母体结局有重大影响。患有主动脉瓣狭窄和心力衰竭的孕妇对心脏团队和麻醉医生来说是一项重大挑战，他们需要权衡不同治疗策略的风险和益处及其对母亲和胎儿的影响。
病例报告
我们介绍了一名26岁的产妇，她在妊娠30周时在心脏外科团队在场的情况下接受了全身麻醉下的剖宫产手术，两周后延期进行主动脉瓣置换术。
结论
本报告描述了多学科术前评估以及精心的手术和麻醉计划对于避免此类患者围手术期心脏状况恶化的重要性。
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