Document Detail


Epidural Anesthesia for Cesarean Delivery in a Patient With Severe Pulmonary Artery Hypertension and a Right-to-Left Shunt.
MedLine Citation:
PMID:  21603339     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
A 38-year-old woman with severe pulmonary artery hypertension and a right-to-left shunt of unknown etiology presented at 32 weeks' gestational age. Determination of the cause of her pulmonary hypertension by transesophageal echocardiography was delayed until after delivery secondary to anesthetic risk. She was successfully anesthetized for cesarean delivery using epidural anesthesia. Systemic vascular resistance was maintained using phenylephrine hydrochloride before delivery and vasopressin after delivery. Transesophageal echocardiography after delivery revealed a patent foramen ovale, indicating a diagnosis of idiopathic pulmonary artery hypertension and a very poor prognosis. Differentiating between Eisenmenger syndrome and idiopathic pulmonary artery hypertension may not be important for determining the optimal anesthetic management of patients with pulmonary hypertension but is important in assessing long-term prognosis.
Authors:
Elizabeth I Krenz; Stuart R Hart; Melissa Russo; Mohi Alkadri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Ochsner journal     Volume:  11     ISSN:  1524-5012     ISO Abbreviation:  Ochsner J     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101125795     Medline TA:  Ochsner J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  78-80     Citation Subset:  -    
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