Anesthetic Management of a Cesarean Delivery in a Patient With MYH11 Mutation Who Underwent Aortic Replacement

Cureus. 2023 Nov 6;15(11):e48391. doi: 10.7759/cureus.48391. eCollection 2023 Nov.

Abstract

We report a case of a pregnant woman with a history of ascending arch replacement for aortic dissection who still had a residual descending aortic dissection. She underwent urgent genetic testing to identify hereditary aortic-related diseases that might be useful in perinatal management. A mutation in the myosin heavy chain gene (MYH11), indicating a high risk of aortic dissection but a low impact on other vascular systems and organs, was identified. Due to concerns about the development of residual aortic dissection, cesarean delivery with combined spinal-epidural anesthesia was selected. Predelivery genetic testing might be useful for perinatal anesthetic management.

Keywords: cesarean delivery; combined spinal-epidural anesthesia; familial thoracic aortic aneurysm and dissection; genetic testing; myh11.

Publication types

  • Case Reports