Open AccessBenefit of transesophageal echocardiography monitoring during cesarean section in a patient with complete atrioventricular canal defect
Author(s) -
Amarpreet Gill,
Dinesh Garg,
Rajesh Arya,
Sunil Katyal,
Gurpreet Gill,
Sunil Kumar Juneja
Publication year - 2016
Publication title -
journal of obstetric anaesthesia and critical care/journal of obstetric anaesthesia and critial care
Language(s) - English
Resource type - Journals
eISSN - 2249-9539
pISSN - 2249-4472
DOI - 10.4103/2249-4472.181070
Subject(s) - medicine , atrioventricular canal , section (typography) , cardiology , heart disease , business , advertising
Anesthesia is a challenge in patients with congenital heart disease, especially during pregnancy and surgical delivery. A 23-year-old with a 34-week gestation, primigravida with atrioventricular (AV) canal defect was scheduled for a cesarean section. Preoperative transthoracic echocardiography (TTE) revealed a complete AV canal defect (Rastelli type II) with left-to-right shunt. Ventricular functions were normal. The patient was administered general anesthesia with endotracheal intubation, and a transesophageal echocardiography (TEE) probe was placed to monitor cardiac functions. The volume status of the parturient and the shunt fraction were continuously monitored with the echocardiography probe during the surgery. Minimal shunting at ventricular septal defect (VSD) was observed, as it was covered by the AV valve leaflets. The patient tolerated the procedure well and the trachea was extubated once she fulfilled the extubation criteria. Intraoperative TEE monitoring was a useful tool to understand and manage hemodynamic variations during cesarean section in the parturient with a complex cardiac lesion