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.
摘要:
右心室双出口(DORV)是一种罕见的心脏病,其中主动脉和肺动脉都来自右心室。导致平行的全身和肺循环。通常,DORV伴有室间隔缺损;然而,室间隔缺损的位置和肺动脉狭窄(PS)的存在导致DORV的各种生理特征和亚型。因为没有PS的DORV会导致充血性心力衰竭,而有PS的DORV会导致紫癜性心脏病,根据由此产生的生理特征,麻醉管理差异很大。由于DORV的发生率低以及这些患者的受孕不鼓励,因此很少有DORV行剖宫产的产妇的麻醉管理报告。以前只报告了8例已知的此类病例,几乎所有这些患者都进行了区域麻醉。在这里,我们描述了DORV的产妇,由于偶然出现低血小板的抗磷脂综合征而对其进行全身麻醉。据我们所知,这种情况以前没有描述过。