title: [Aortic coarctation and postcoarctation mycotic aneurysm in a woman 20 weeks pregnant: anesthetic management].
abstract: A 28-year-old woman, 20 weeks pregnant, was diagnosed with aortic coarctation and postcoarctation mycotic aneurysm. After anesthetic induction, blood pressure was monitored in the radial artery of the right arm and the femoral artery of the right leg for two purposes: to verify hemodynamic stability as required in this type of operation and to determine the pressure gradient between the upper and lower limbs, which was approximately 40 mm Hg. To prevent spinal cord ischemia, an intradural catheter was inserted into the fourth and fifth lumbar space for spinal fluid drainage. A double lumen tube was used for intubation so that the left lung could be blocked, and a centrifugal pump was used instead of extracorporeal circulation. The aneurysm was resected through a left thoracotomy and an aortic prosthesis was placed. Satisfactory outcome was indicated by resolution of the pressure gradient, and fetal viability was verified by ultrasound. The mother suffered no neurological complications and the pregnancy continued to term uneventfully. We review the anesthetic procedure to follow in such cases.
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid.
authors.forename: A
authors.initials: A
authors.lastname: Reyes
authors.forename: F
authors.initials: F
authors.lastname: de la Gala
authors.forename: I
authors.initials: I
authors.lastname: Canal
authors.forename: J M
authors.initials: JM
authors.lastname: Barrio
authors.forename: J
authors.initials: J
authors.lastname: Hortal
authors.forename: M
authors.initials: M
authors.lastname: Riesgo
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000785:Aneurysm, Infected / Q000150:complications / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011262:Pregnancy Trimester, Second