Anesthetic Management of a Pregnant Patient Who Underwent Surgery Due to Stuck Valve

In conclusion the operation on the pregnant woman with nonfunctional mitral valve was successfully performed without any maternal and fetal complication following an appropriate anesthetic and surgical planning.

📌 3 Key Takeaways

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Objective & Hypothesis:We report anesthetic management of a prosthetic valve thrombosis on a 28th week pregnant women, with acute heart failure and pulmonary oedema.

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Key Findings & Data:Transthoracic echocardiography revealed EF 55%, dysfunctional prosthetic mitral valve, restricted leaflet opening, severe dilatation in right atrium, pulmonary artery pressure of 65 mmHg, aorta insufficiency of 2-3. degree, tricuspid incompetence of 2. degree.

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Conclusion & Impact:In conclusion the operation on the pregnant woman with nonfunctional mitral valve was successfully performed without any maternal and fetal complication following an appropriate anesthetic and surgical planning.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

We report anesthetic management of a prosthetic valve thrombosis on a 28th week pregnant women, with acute heart failure and pulmonary oedema. A twenty-eight-week pregnant patient who visited a hospital with a complaint of dyspnea was sent to our clinic to undergo an urgent surgical intervention after diagnosed with mitral valve replacement stuck valve. Transthoracic echocardiography revealed EF 55%, dysfunctional prosthetic mitral valve, restricted leaflet opening, severe dilatation in right atrium, pulmonary artery pressure of 65 mmHg, aorta insufficiency of 2-3. degree, tricuspid incompetence of 2. degree. The surgeons observed mild cyanosis in extremities and lips, tachypnea, orthopnea, hemoptysis while the patient was on the operating table. Thrombolytic treatment was refused by the patient. The patient’s mitral valve was replaced with cardiopulmonary bypass procedure following the live delivery of the baby with c-section under general anesthesia. In conclusion the operation on the pregnant woman with nonfunctional mitral valve was successfully performed without any maternal and fetal complication following an appropriate anesthetic and surgical planning.

Özet

Mitral kapakta tromboz nedeniyle stuck kapak saptanan ve buna bağlı olarak akut kalp yetmezliği ve pulmoner ödem tablosunda acil ameliyata aldığımız 28 haftalık gebenin anestezi yönetimi sunulmuştur. Nefes darlığı yakınması ile başvuran 28 haftalık gebe, MVR (mitral valve replacement) stuck kapak saptanması üzerine acil ameliyat için hastanemize sevkedilmiştir. Transtorasik ekokardiyografisinde EF %55, protez mitral kapak disfonksiyene, açılımı kısıtlı, sağ boşlukları ileri derecede dilate, pulmoner arter basıncı 65 mmHg, 2.-3. derece aort yetmezli- ği, 2. derece triküspit yetmezliği mevcuttu. Ameliyat masasına alınan hastada, ekstremite uçlarında ve dudaklarda hafif siyanoz, takipne, ortopne ve hemoptizi mevcuttu. Batın ultrasonografide uterusta 28 haftalık canlı fetüs olduğu tespit edildi. Hastanın, isteği doğrultusunda trombolitik tedavi başlanmadı. Genel anestezi altında önce sezaryen ile bebek canlı olarak doğurtuldu ve ardından kardiyopulmoner baypass ile mitral kapak değişimi yapıldı. Nonfonksiyone mitral kapak nedeniyle ameliyata aldığımız gebede uygun bir anestezi ve cerrahi planlama yapılarak anne ve bebekte komplikasyon yaşanmadan operasyon tamamlandı.

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Cite This Article

KAŞIKARA, H., KÜÇÜKER, A., YILDIRIM, M., ALTIN, C., UĞUR, G., AKSOY, Ş. M., BUT, A. (2016). Anesthetic Management of a Pregnant Patient Who Underwent Surgery Due to Stuck Valve. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, Cilt: 22 - Sayı: 1, 34–37. https://ajindex.com/articles/186406

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