Anesthetic experience using extracorporeal membrane oxygenation for cesarean section in the patient with peripartum cardiomyopathy: a case report

Kim, Han-Young; Jeon, Hyung-joon; Yun, Ji-Hyun; Lee, Jong-Hyuk; Lee, Gang-Geon; Woo, Seong-Chang

doi:10.4097/kjae.2014.66.5.392

Cited by 9 publications

(8 citation statements)

References 15 publications

(53 reference statements)

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“…There have been a few published reports of extracorporeal life support use in pregnant women with PPCM. [23][24][25][26] Only one of the reported patients underwent cesarean section with PCPS support, 26 whereas the remaining patients were treated after delivery. Bouabdallaoui et al reported 10 consecutive patients with PPCM who received veno-arterial-ECMO.…”

Section: Discussionmentioning

confidence: 99%

Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report

et al. 2021

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Perioperative management of pregnant women with heart failure is difficult. Management of anesthesia in pregnant women is especially difficult because all of the currently available choices present challenges. We report a patient with peripartum cardiomyopathy (PPCM) who required an emergent cesarean section and discuss the possible tactics for managing anesthesia. A 40-year-old primipara with severe cardiac and respiratory failure required an emergent cesarean section at 39+1 gestational weeks. Her left ventricular ejection fraction was between 10% and 15%, and she had orthopnea. General anesthesia was planned after inserting sheaths for percutaneous cardiopulmonary support from the femoral artery and vein. However, when the patient was asked to lie down on the operation bed, she panicked and resisted because of labor pain and dyspnea. Therefore, anesthesia was induced instead of the initial plan. Finally, we successfully managed the anesthesia and delivered the newborn. There are no alternatives to general anesthesia in patients with PPCM presenting with orthopnea. Anesthesia induction in the supine position is impossible in such patients owing to dyspnea. Anesthesia should be started with light sedation in the sitting position, and ketamine or low-dose remifentanil may be an option to maintain maternal hemodynamics and prevent neonatal asphyxia.

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Section: Discussionmentioning

confidence: 99%

Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report

et al. 2021

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“…One case describes a 34-year-old at term gestation who presented with acutely worsening heart failure and cesarean delivery was performed after full flow ECMO support was established. ECMO was maintained for five days after surgery [14]. In another case an 18-year-old woman developed decompensated heart failure immediately after cesarean delivery and was placed on ECMO as a bridge to recovery.…”

Section: Discussionmentioning

confidence: 99%

Preemptive ECMO Cannulation in a Patient with Severe Left Ventricular Systolic Dysfunction Undergoing Cesarean Delivery

Bui

Mascaro

Henao-Mejia

et al. 2019

Case Reports in Anesthesiology

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Obstetric patients with heart failure undergoing cesarean delivery are high risk and the perioperative care of these patients poses significant multidisciplinary challenges. In contrast to the nonobstetric patient population the potential role of mechanical circulatory support in parturients with heart failure is not well established and the use of extracorporeal membrane oxygenation (ECMO) has rarely been reported. We report the case of a super morbidly obese patient with decompensated heart failure, pulmonary hypertension, and superimposed preeclampsia undergoing preemptive ECMO cannulation for urgent cesarean delivery.

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“…Anesthesiologists are commonly involved during the delivery phase of those parturients with PPCM by providing anesthesia for cesarean section. Either of general or regional anesthesia have been successfully applied in PPCM in multiple of case reports [16,17]. There is no evidence supporting that general is superior to the neuraxial anesthesia, or vice versa.…”

Section: Discussionmentioning

confidence: 99%

Application of point of care transthoracic echocardiography in parturient with peripartum cardiomyopathy undergoing lower segmental cesarean section- 2 cases report

Su¹,

Y²,

Xp³

et al. 2018

Case Rep Imag Surg

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Background: Peripartum cardiomyopathy is one form of life-threatening dilated cardiomyopathy which occurs in previously healthy women in the final months of pregnancy and up to 5 months after delivery. The etiology of peripartum cardiomyopathy remains poorly understood but inflammation or virus-mediated autoimmune reaction to myocardial cells was proposed to be involved in the pathogenesis of peripartum cardiomyopathy. Obstetric management for those parturients requires communication and careful planning between obstetrics, cardiology and anesthesiology. Case presentation:The first case is a 22-year-old woman presented as gravida 1, para 0, at 38+4 weeks of gestation with the deterioration of dyspnea on exertion and palpitation over the past several days. According to TTE report from cardiac based echocardiography unit, there was a decline in systolic function manifested by overall global wall motion abnormality with EF only 28%. In the second case, A 44-year-old pregnant woman presented at the same hospital with progressing shortness of breath, chest pain and faintness which was diagnose peripartum cardiomyopathy also. Conclusion:The application of point of care echocardiography might have a beneficial impact on the selection of anesthesia and maintaining the hemodynamic stability of the parturient with peripartum cardiomyopathy undergoing cesarean section. This paper reported two parturients suffering from peripartum cardiomyopathy with acute heart failure undergoing lower segmental cesarean section uneventfully throughout the perioperative period under the guidance of point of care transthoracic echocardiography. Highlights• Intraoperative transthoracic echocardiography (TTE) plays an important role in identifying the undifferentiated causes of dyspnea of parturient with peripartum cardiomyopathy (PPCM), decision making on the anesthetic management and also evaluating the response to therapeutic intervention during the low segmental cesarean section (LSCS).• Point of care TTE was a useful tool to detect the global or segmental wall motion abnormality of left ventricle as well as right ventricle filling through utility of continuous noninvasive superficial echocardiography in parturients with PPCM undergoing LSCS.

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Anesthetic experience using extracorporeal membrane oxygenation for cesarean section in the patient with peripartum cardiomyopathy: a case report

Cited by 9 publications

References 15 publications

Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report

Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report

Preemptive ECMO Cannulation in a Patient with Severe Left Ventricular Systolic Dysfunction Undergoing Cesarean Delivery

Application of point of care transthoracic echocardiography in parturient with peripartum cardiomyopathy undergoing lower segmental cesarean section- 2 cases report

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