Combined spinal-epidural anesthesia for cesarean delivery in a patient with cor triloculare biventriculare

Abstract

Background: Cor triloculare biventriculare accounts for approximately 0.31% of cases of congenital heart disease (CHD). Moreover, people with cor triloculare biventriculare always have shorter life spans, and cases of gestation are rare. There have been various related reports of cor triloculare biventriculare in recent years.

Case presentation: We described an emergency cesarean section of a 30-year-old, 38-weeks-pregnant woman suffering from cardiac insufficiency and fetal distress. Combined spinal-epidural anesthesia was performed safely, and a male baby was smoothly delivered 10 min after the procedure without any adverse outcome on the mother or newborn. After surgery, we advised that the patient submit to an echocardiogram examination, which revealed the congenital heart disease cor triloculare biventriculare.

Conclusions: Combined spinal-epidural anesthesia was administered to a patient with cor triloculare biventricularethis with good effect, ensuring the patient's safety and meeting the need for emergency surgery.

Keywords: Anesthesia; Case report; Cor triloculare biventriculare; Heart disease; Obstetric anesthesia.

Fig. 1

Echocardiogram of the patient’s heart, showing a single atrium. The following parameters were described: pulmonary artery, 27 mm; right ventricular diameter, 39 mm; left ventricular end diastolic diameter (LVEDD), 43 mm; left ventricular ejection fraction (LVEF), 51%; E/A, 1.01/0.69; pulmonary pressure, 16 mmHg. The echocardiogram showed evidence of congenital heart disease (CHD), including no visible nub of the interatrial septum on any section, a single atrium (SA), pulmonary artery enlargement, right ventricular hypertrophy, mitral and tricuspid valves located at the same level, poor valve development, mitral valve moderate regurgitation, tricuspid moderate regurgitation, and disappearance of the endocardial cushion decussation