[Anesthesia for section caesarean with aortic dissection in Marfan Syndrome]

Marfan Syndrome (MFS) is associated with an increased anaesthesia risk because of the pathological manifestations in anaesthesia-relevant organ systems. If, in addition, a typical MFS complication - acute aortic dissection - presents and this in pregnant patients, a high-risk anaesthesia must be assumed. In the case reported, a 30 year old woman in the 35 th week of gestation presented with an acute aortic dissection, initially in the region of the descending aorta and later, in the course of the ascending aorta. An urgent Caesarean section was indicated in order to perform the equally urgent vascular surgery as quickly as possible. The most important goal of the anaesthesia management is to determine an anaesthesia procedure which addresses the combination of aorta dissection, gestation and MFS. On the one hand, the risk of an aorta rupture needs to be kept as low as possible and on the other hand, the vital functions of the baby have to be maintained. A general anaesthesia procedure under mild controlled hypotension was selected. Optimal monitoring and absolute freedom from pain were the prerequisites both for the anaesthesia management of the Caesarean section as well as for the immediate transport to a clinic for further treatment after completion of anaesthesia.