Anesthetic Management of a Unique Case of Double-Outlet Right Ventricle With Glenn Shunt for Cesarean Delivery: A Case Report.

Abstract

Double-outlet right ventricle is a rare congenital cardiac anomaly resulting in intracardiac mixing of oxygenated and deoxygenated blood. Surgical palliation involves staged conversion to Fontan circulation, with an intermediate stage using a Glenn shunt. We report the case of a patient at 36 weeks of gestation, with a partially palliated double-outlet right ventricle and a Glenn shunt, who presented with severe dyspnea and worsening cyanosis. After preoperative optimization, a combined spinal-epidural technique was successfully used for cesarean delivery. The anesthetic concerns and perioperative management of patients with complex cardiac physiology are discussed in this report. Carefully titrated combined spinal-epidural technique can be safe and effective for such cases.

• Authors: Ajisha Aravindan, Rajeshwari Subramaniam, Praveen Talawar, Sumit Bansal, Riddhi Kundu, Priyankar Kumar Datta
• Journal: AANA journal (AANA J) Vol. 86 Issue 5 Pg. 408-411 (Oct 2018) ISSN: 2162-5239 [Electronic] United States
• PMID: 31584411 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright© by the American Association of Nurse Anesthetists.

Topics

• Adult
• Anesthesia, Obstetrical
• Cesarean Section
• Cyanosis (diagnosis, etiology, nursing)
• Diagnosis, Differential
• Double Outlet Right Ventricle (complications)
• Female
• Gestational Age
• Humans
• Nurse Anesthetists
• Pregnancy
• Pregnancy Complications, Cardiovascular