[Anesthetic management for cesarean section in a patient with corrected transposition of great arteries]

A 20-year-old woman with corrected transposition of great arteries (height 163 cm, weight 69 kg) was scheduled for elective cesarean section at 36 weeks of gestation. Since her mitral insufficiency had deteriorated during pregnancy, she developed dyspnea and lower cardiac function. We decided to perform general anesthesia for her cesarean section. Under the continuous monitoring of arterial blood pressure, anesthesia induction was performed with thiamylal 150 mg, vecuronium 8 mg and fentanyl 0.2 mg, and maintained with oxygen-air-isoflurane (1-1.5%). A Swan-Ganz catheter was inserted for evaluation of her cardiac function. No cardiac events were observed during surgery. The postoperative course was uneventful, and the patient was discharged from the hospital on the 10th postoperative day. Swan-Ganz catheter was useful for the evaluation of cardiac function and for anesthetic management.