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Journal of Obstrectic Anaesthesia and Critical Care
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CASE REPORT
Year : 2016  |  Volume : 6  |  Issue : 1  |  Page : 25-27

Benefit of transesophageal echocardiography monitoring during cesarean section in a patient with complete atrioventricular canal defect


1 Department of Anaesthesia and Critical Care, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
2 Department of Cardiac Anaesthesia, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
3 Department of Obstetrics and Gynecology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India

Correspondence Address:
Dr. Rajesh Chand Arya
Department of Cardiac Anaesthesia, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4472.181070

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Anesthesia is a challenge in patients with congenital heart disease, especially during pregnancy and surgical delivery. A 23-year-old with a 34-week gestation, primigravida with atrioventricular (AV) canal defect was scheduled for a cesarean section. Preoperative transthoracic echocardiography (TTE) revealed a complete AV canal defect (Rastelli type II) with left-to-right shunt. Ventricular functions were normal. The patient was administered general anesthesia with endotracheal intubation, and a transesophageal echocardiography (TEE) probe was placed to monitor cardiac functions. The volume status of the parturient and the shunt fraction were continuously monitored with the echocardiography probe during the surgery. Minimal shunting at ventricular septal defect (VSD) was observed, as it was covered by the AV valve leaflets. The patient tolerated the procedure well and the trachea was extubated once she fulfilled the extubation criteria. Intraoperative TEE monitoring was a useful tool to understand and manage hemodynamic variations during cesarean section in the parturient with a complex cardiac lesion.


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