General Anesthesia for Cesarean Section in a Pregnant Woman with Truncus Arteriosus Intraoperatively Monitored by Transesophageal Echocardiography

Abstract

Truncus arteriosus (TA) is defined as a congenital cardiovascular malformation in which one great artery arises from the base of the heart and gives origin to the pulmonary and systemic arteries. TA patients who become pregnant have high morbidity and mortality rates because physiologic changes during pregnancy can worsen the cardiopulmonary balance causing cardiopulmonary decompensation. In this case report we report a successful general anesthesia in a truncus arteriosus patient with severe pulmonary hypertension (Eisenmenger syndrome) who underwent a full-term pregnancy delivery monitored by intraoperative transesophageal echocardiography, a new technique to assist physicians in dealing with patients with hemodynamic instability during both cardiac and noncardiac surgery.

Intraoperative Hemodynamic Fluid Therapy for Immediate- to Highrisk Non-cardiac Surgery: A Narrative Review

“…Transthoracic or transesophageal echocardiography can be used to monitor RV dilation, RV systolic function, LV function, and the central vein, and in selected cases, monitoring pulmonary artery pressure can be useful. [43][44][45] During intraoperative hemodynamic management, not all patients who show fluid responsiveness require fluids; for example, patients with adequate or high SV or CO may not require fluid administration even if they are fluid responders. Assessments of fluid responsiveness should…”