He Shan, Huynh Christopher A, Deng Yi, Markan Sandeep, Nguyen Anvinh
Anesthesiology, Baylor College of Medicine, Houston, USA.
Cureus. 2021 Dec 6;13(12):e20209. doi: 10.7759/cureus.20209. eCollection 2021 Dec.
A 39-year-old patient presented to our Labor and Delivery unit with fever and nausea in the context of recent bacteriuria. She was found to be in sepsis due to an incidental bicuspid aortic valve (BAV) complicated by aortic valvular vegetations, severe aortic insufficiency, and aortic root abscess, requiring an emergent cesarean section. Three days after delivery, the patient successfully underwent a mechanical aortic valve replacement and root reconstruction. In this case report, medical, surgical, and anesthetic management of parturient patients with BAV are discussed. The management of this congenital valvulopathy and vasculopathy is complicated by the extensive hemodynamic and cardiovascular derangements that occur during pregnancy.
一名39岁患者因近期患菌尿症，出现发热和恶心症状，前来我院产科就诊。她被诊断为脓毒症，病因是偶然发现的二叶式主动脉瓣（BAV），并发主动脉瓣赘生物、严重主动脉瓣关闭不全和主动脉根部脓肿，需要紧急剖宫产。分娩三天后，患者成功接受了机械主动脉瓣置换和根部重建手术。在本病例报告中，讨论了患有BAV的产妇的药物、手术和麻醉管理。这种先天性瓣膜病和血管病的管理因妊娠期间发生的广泛血流动力学和心血管紊乱而变得复杂。
