Anesthetic Management of a Parturient With Double-Outlet Right Ventricle Obstruction and Pulmonary Stenosis Scheduled for Cesarean Delivery: Case Report and Review of Literature

AANA J. 2021 Dec;89(6):523-528.

Abstract

Double-outlet right ventricle (DORV) is a rare cardiac condition in which both the aorta and pulmonary artery arise from the right ventricle, resulting in parallel systemic and pulmonary circulations. Usually, DORV is present with ventricular septal defect; however, the location of the ventricular septal defect and presence of pulmonary stenosis (PS) result in various physiological features and subtypes of DORV. Because DORV without PS causes congestive cardiac failure and DORV with PS results in cyanotic heart disease, anesthesia management varies widely according to the resultant physiological characteristics. Reports of anesthesia management in a parturient with DORV undergoing cesarean delivery is scarce because of the low incidence of DORV and the discouragement of these patients to conceive. Only 8 known previous such cases are reported, and almost all these patients were administered regional anesthesia. Here we describe a parturient with DORV, to whom general anesthesia was administered because of incidental antiphospholipid syndrome with low platelets. To the best of our knowledge, this scenario has not been described previously.

Keywords: Anesthesiology; cardiac; double-outlet right ventricle; pulmonary stenosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anesthetics*
  • Cesarean Section
  • Double Outlet Right Ventricle* / complications
  • Double Outlet Right Ventricle* / surgery
  • Female
  • Humans
  • Pregnancy
  • Pulmonary Valve Stenosis* / complications
  • Pulmonary Valve Stenosis* / surgery

Substances

  • Anesthetics