• Vishnu Datt, Deepak K Tempe, Sanjula Virmani, Devesh Datta, Mukesh Garg, Amit Banerjee, and Akhlesh S Tomar.
• Department of Anesthesiology, GB Pant Hospital, New Delhi, India. dattvishnu@yahoo.com
• Ann Card Anaesth. 2010 Jan 1;13(1):64-8.

AbstractAsymptomatic women with mild aortic stenosis (AS) and normal left ventricular functions can successfully carry pregnancy to term and have vaginal deliveries. However, severe AS (valve area <1.0 cm2) can result in rapid clinical deterioration and maternal and fetal mortality. So, these patients require treatment of AS before conception or during pregnancy preferably in the second trimester. In suitable patients percutaneous balloon aortic valvotomy appears to carry lower risk. It can also be used as a palliative procedure allowing deferral of aortic valve replacement until after delivery. The present patient had severe critical AS with congestive heart failure that was refractory to medical therapy and the fetus was viable (>28 wks). So, combined lower segment cesarean section and aortic valve replacement were performed under opioid based general anesthesia technique to reduce the cardiac morbidity and mortality.

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