Document Detail


Successful management of a patient with Marfan syndrome complicated with acute aortic dissection using landiolol during Cesarean section.
MedLine Citation:
PMID:  20101513     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Aortic dissection is a lethal complication in pregnant women with Marfan syndrome. To decrease arterial wall stress, beta-blockers have been used as standard treatment, although uterine contractions caused by beta-2-adrenergic receptor antagonism may result. Herein, we report a patient with Marfan syndrome who was given landiolol, a selective beta-1-adrenergic receptor antagonist with a short half-life, for management during a Cesarean section procedure following development of acute aortic dissection. A 30-year-old pregnant woman with Marfan syndrome in the 38th week of gestation was referred to our department for an emergency Cesarean section because of development of acute aortic dissection. Blood pressure (BP) decreased from 157/70 to 128/64 mmHg after giving nicardipine and nitroglycerin. However, heartrate (HR) increased from 112 to 145 bpm, which was reduced to 105 bpm with landiolol, while BP was maintained. A Cesarean section was performed without complications under combined spinal-epidural anesthesia. Hemodynamic state, uterine contraction, and the extent of aortic dissection remained stable. The postoperative course was uneventful, and the patient and her baby were discharged safely. Landiolol was useful for reduction of HR without affecting BP or uterine contractions during a Cesarean section procedure in our patient with aortic dissection.
Authors:
Noboru Saeki; Shima Taguchi; Masashi Kawamoto
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Publication Detail:
Type:  Journal Article     Date:  2010-01-26
Journal Detail:
Title:  Journal of anesthesia     Volume:  24     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  277-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Critical Care, Hiroshima University Hospital, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. nsaeki@hiroshima-u.ac.jp
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