• E Alon and H Baumann.
• Institut für Anaesthesiologie, Universitätsspital Zürich.
• Reg Anaesth. 1988 Jan 1;11(1):28-31.

AbstractThe maternal mortality associated with cesarean section in the presence of congenital cyanotic heart disease is high. We report the anesthetic management of a 26-year-old pregnant patient with transposition of the great vessels and a functional single ventricle whose child was delivered by elective cesarean section under continuous epidural anesthesia. There were no hemodynamic problems and the outcome was successful for both mother and child, who could be discharged from the hospital on the 17th postoperative day. Elective cesarean section may be an acceptable method of delivery, and lumbar epidural block proved to be an appropriate procedure for this patient. The cooperation of cardiologists, anesthesiologists, and obstetricians was necessary to assure maternal and fetal survival. Continuous invasive hemodynamic monitoring and use of small epidural top-up doses (2-3 ml) of local anesthetic were of utmost importance in maintaining the hemodynamic stability.

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