Wojciech Dąbrowski, Ziemowit Rzecki
CaseRepClinPractRev 2005; 6:327-331
Backround: Congenital heart defects are a very difficult problem in anesthesiology. The most serious cases are cyanotic heart defects which are life-threatening, particularly during noncardiac procedures. Anaesthesia and postoperative treatment are very difficult in such cases, the most dangerous
ones are emergency operations, e.g. Caesarean section.
The aim of this study was to analyse five cases of anaesthesia for Caesarean section in patients
with uncorrected cyanotic congenital heart defect.
Case Report: The study was based on retrospective analysis of four cases. Two patients had Fallot’s tetralogy, one – VSD and one - Ebstain defect. The last patient was anaesthetized twice. One case of Fallot’s tetralogy underwent epidural anaesthesia with good result, the second one had general anaesthesia with fatal effect. The woman with VSD died after general anaesthesia. The patient with Ebstain defect was subjected to general anaesthesia during her first Cesarean section (complicated by
pulmonary oedema) and to epidural anaesthesia during the second procedure performed two years later (with good result).
Conclusions: The epidural anaesthesia for Cesarean section is the method of choice in patients with uncorrected cyanotic heart defect.
Keywords: caesarean section, cyanotic heart defect, epidural anaesthesia, general anaesthesia