Cruz Mark Andrew B, Cruz Ma Concepcion L
Department of Anesthesiology, College of Medicine and Philippine General Hospital, University of the Philippines Manila.
Acta Med Philipp. 2024 May 23;58(9):59-64. doi: 10.47895/amp.v58i9.8746. eCollection 2024.
Ruptured Sinus of Valsalva (RSOV) is a rarely encountered cardiac anomaly that can potentially lead to adverse clinical outcomes. RSOV increases the risk of morbidity during pregnancy due to the physiological changes associated with gestation, that can exacerbate the underlying cardiac pathology. We present the case of a 29-year-old female with an uncorrected RSOV who required an emergency cesarean section for abruptio placenta. The patient underwent the procedure under spinal anesthesia, with careful titration of norepinephrine infusion and close monitoring of hemodynamic parameters using an invasive intra-arterial line. Given the absence of established anesthetic protocols for parturients with RSOV undergoing cesarean delivery, a comprehensive understanding of the complex interaction between the hemodynamic effects of RSOV, pregnancy, and anesthesia is essential. This understanding enables the safe use of spinal anesthesia in urgent situations, leading to favorable patient outcomes.
瓦氏窦破裂(RSOV)是一种罕见的心脏异常,可能导致不良临床后果。由于妊娠相关的生理变化,RSOV会增加孕期发病风险,这些变化会加重潜在的心脏病理状况。我们报告一例29岁未矫正RSOV的女性病例,该患者因胎盘早剥需要紧急剖宫产。患者在脊髓麻醉下接受手术,谨慎滴定去甲肾上腺素输注量,并使用有创动脉导管密切监测血流动力学参数。鉴于目前尚无针对接受剖宫产的RSOV产妇的既定麻醉方案,全面了解RSOV、妊娠和麻醉的血流动力学效应之间的复杂相互作用至关重要。这种了解有助于在紧急情况下安全使用脊髓麻醉,从而使患者获得良好预后。