Ruiz-Castro M, Sanz M, Vidal A, Infante B, Palma M A
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid.
Rev Esp Anestesiol Reanim. 1996 Oct;43(8):291-3.
Mitral valve prolapse is the most frequent cardiac valvulopathy. Given its greater incidence in young women it is a factor which must be taken into account when performing cesarean section. Two patients with mitral valve prolapse in whom a cesarean section was carried out are presented: case 1, a 22-year-old woman, ASA II, 72 kg, with mitral valve prolapse associated with the Wolf-Parkinson-White syndrome and an episode of paroxysmal supraventricular tachycardia. The cesarean section which was indicated because of the absence of fetal progression was performed under epidural anesthesia. Forty-five minutes after regional blockade a hypotensive episode was observed which remitted following the i.v. administration of 6 mg of methoxamine. No other complication was reported. The Apgar score of the neonate at one minute was 7; case 2, a 31 year-old woman, ASA II, 51 kg, diagnosed with mitral valve prolapse with no associated symptomatology. A cesarean section was performed in this patient because of pedal presentation under general anesthesia without complications. The Apgar score of the neonate at one minute was 8. The physiopathology of mitral valve prolapse as well as anesthesia management during cesarean section in this type of valvulopathy is reviewed.
二尖瓣脱垂是最常见的心脏瓣膜病。鉴于其在年轻女性中发病率较高，在进行剖宫产时这是一个必须考虑的因素。本文介绍了两名行剖宫产的二尖瓣脱垂患者：病例1，一名22岁女性，ASA II级，体重72 kg，患有与预激综合征相关的二尖瓣脱垂及阵发性室上性心动过速发作。因胎儿无进展而行剖宫产，手术在硬膜外麻醉下进行。区域阻滞45分钟后出现低血压发作，静脉注射6 mg甲氧明后缓解。未报告其他并发症。新生儿1分钟时阿氏评分7分；病例2，一名31岁女性，ASA II级，体重51 kg，诊断为二尖瓣脱垂且无相关症状。因足先露在全身麻醉下行剖宫产，无并发症。新生儿1分钟时阿氏评分8分。本文对二尖瓣脱垂的病理生理学以及此类瓣膜病剖宫产期间的麻醉管理进行了综述。
