[Anesthesia for cesarean section in patients with mitral valve prolapse].
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.
Ruiz-Castro
M
M
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid.
Sanz
M
M
Vidal
A
A
Infante
B
B
Palma
M A
MA
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local / Q000009:adverse effects / Q000494:pharmacology; D002045:Bupivacaine / Q000009:adverse effects / Q000494:pharmacology; D002585:Cesarean Section; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000188:drug therapy; D008729:Methoxamine / Q000627:therapeutic use; D008945:Mitral Valve Prolapse / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D013617:Tachycardia, Supraventricular; D014927:Wolff-Parkinson-White Syndrome
D000779:Anesthetics, Local; D008729:Methoxamine; D002045:Bupivacaine