Seminars in cardiothoracic and vascular anesthesia
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Semin Cardiothorac Vasc Anesth · Sep 2011
Review Case ReportsManagement of acquired cardiac disease in the obstetric patient.
Physiologic changes incurred by pregnancy can cause severe decompensation in the parturient with underlying cardiac disease. The result is increased morbidity and mortality for both mother and child. Appropriate anesthetic management can significantly impact these outcomes. This review systematically presents the pathophysiology, peripartum risk, and anesthetic management in the puerperium of specific acquired cardiac abnormalities including: valvular disease, pulmonary hypertension, cardiomyopathy, cardiac transplantation, ischemia, arrhythmias, and cardiac arrest.
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Semin Cardiothorac Vasc Anesth · Sep 2011
Cesarean delivery and colon resection in a patient with type III osteogenesis imperfecta.
OBJECTIVE. Osteogenesis imperfecta is a connective tissue disorder that results from the inability to produce normal collagen. Eight types are described; type II is considered the lethal variant. ⋯ CLINICAL CHALLENGES. (a) Preoperative assessment of an osteogenesis imperfecta patient, (b) determination of anesthetic type, (c) management of hemorrhage/cardiovascular instability, and (d) management of hyperthermia. CONCLUSIONS. This case report illustrates that, with proper knowledge of this disease state, osteogenesis imperfecta patients can undergo a safe anesthetic during a potentially challenging combined cesarean section/colonic resection.