Zhang Y, Wei TT, Chen G. Anesthetic management of a pregnant patient with Eisenmenger’s syndrome: A case report. World J Clin Cases 2023; 11(27): 6597-6602 [PMID: 37900253 DOI: 10.12998/wjcc.v11.i27.6597]
Corresponding Author of This Article
Gang Chen, PhD, Chief Doctor, Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 Qingchun Road, Hangzhou 310006, Zhejiang Province, China. chengang120@zju.edu.cn
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2023; 11(27): 6597-6602 Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6597
Anesthetic management of a pregnant patient with Eisenmenger’s syndrome: A case report
Ying Zhang, Ting-Ting Wei, Gang Chen
Ying Zhang, Ting-Ting Wei, Gang Chen, Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, Zhejiang Province, China
Author contributions: Zhang Y and Chen G reviewed the literature and contributed to manuscript drafting; Zhang Y and Wei TT analyzed and interpreted the imaging findings; Zhang Y, Wei TT, and Chen G were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gang Chen, PhD, Chief Doctor, Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3 Qingchun Road, Hangzhou 310006, Zhejiang Province, China. chengang120@zju.edu.cn
Received: June 24, 2023 Peer-review started: June 24, 2023 First decision: July 28, 2023 Revised: August 8, 2023 Accepted: August 17, 2023 Article in press: August 17, 2023 Published online: September 26, 2023 Processing time: 84 Days and 3.1 Hours
Abstract
BACKGROUND
Eisenmenger’s syndrome (ES) is a rare complication of congenital heart disease that includes pulmonary artery hypertension and reversed or bidirectional shunts. The mortality rate of pregnant women with ES is 30%-70% due to pathophysiological deterioration. Successful perioperative management of a pregnant patient with ES is a challenge for anesthesiologists.
CASE SUMMARY
A 38-year-old pregnant woman was admitted to the cardiology department of our hospital at 22 wk of gestation with complaints of chest tightness and shortness of breath for 3 wk. Transthoracic echocardiography revealed a bidirectional shunt between the descending aorta and pulmonary artery after interventional closure of the patent ductus arteriosus and severe pulmonary hypertension. ES in pregnancy was our primary suspicion. The patient elected to terminate the pregnancy under adequate preoperative preparation, rigorous intraoperative monitoring, and perfect epidural anesthesia. She was discharged successfully on postoperative day 16.
CONCLUSION
Our experience in this case suggests that successful outcomes are possible in pregnant patients with ES for termination of pregnancy under epidural anesthesia and intensive monitoring.
Core Tip: Eisenmenger’s syndrome (ES) is a rare complication of congenital heart disease, with a high maternal mortality of 30%-70%. We present a rare case of a pregnant woman with ES after cardiac surgery. The patient elected to terminate the pregnancy under adequate preoperative preparation, rigorous intraoperative monitoring, and perfect epidural anesthesia. Our experience in this case suggests that successful outcomes are possible in pregnant patients with ES for termination of pregnancy under epidural anesthesia and intensive monitoring.
