title: Safe management of cesarean section in a patient of Eisenmenger syndrome.
abstract: We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO) (as a bridge to recovery or bridge to salvage) was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.
authors.affiliation: Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Minicucci
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Segala
authors.forename: Claudio
authors.initials: C
authors.lastname: Verdecchia
authors.forename: Piero
authors.initials: P
authors.lastname: Sismondi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casabona
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sansone
mesh_terms: D002585:Cesarean Section; D004541:Eisenmenger Complex / Q000503:physiopathology*; D015199:Extracorporeal Membrane Oxygenation; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*