title: [Anesthesia for cesarean section in a patient with cor triatriatum].
abstract: Cor triatriatum is a rare congenital cardiac anomaly, in which left ventricular filling is impeded by obstructive membrane in the left atrium. We administered spinal anesthesia for cesarean section in a patient with cor triatriatum (type III A1) with congestive heart failure. We optimized hemodynamics with the aid of pulmonary artery cathter. In general, cor triatriatum involves similar hemodynamic profiles to mitral stenosis and thus tachycardia should be avoided during anesthesia. However, in our patient, increasing the heart rate to 80-90 beats x min(-1) was beneficial in maintaining adequate systemic blood pressure and cardiac output. Spinal anesthesia could be a method of choice for cesarean section in a patient with cor triatriatum when adequate hemodynamic monitoring is available.
authors.affiliation: Department of Anesthesiology, Kansai Medical University, Moriguchi 570-8506.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kanbara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Miyake
authors.forename: Kohei
authors.initials: K
authors.lastname: Murao
authors.forename: Sachiko
authors.initials: S
authors.lastname: Jomura
authors.forename: Makiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Norihito
authors.initials: N
authors.lastname: Sato
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakao
authors.forename: Koh
authors.initials: K
authors.lastname: Shingu
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002585:Cesarean Section; D003310:Cor Triatriatum / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D014463:Ultrasonography