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Cesarean Delivery in a Parturient With "Repaired" Congenital Mitral Dysplasia and Severe Functional Mitral Stenosis:

Erica M Johnson1, James A Dolak

  • 1From the Department of Anesthesiology, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, and Emory University Hospital Midtown, Atlanta, Georgia.

A&A Practice
|August 14, 2020
PubMed

We present the anesthetic management of a 23-year-old gravida 2 para 0-0-1-0 with a history of mitral valve replacement secondary to congenital mitral dysplasia. The hemodynamic changes of pregnancy had resulted in severe functional mitral stenosis of her mechanical valve, which was significantly undersized for her current body surface area. Her complex cardiac history required our multidisciplinary team to focus on peripartum anticoagulation management, extracorporeal membrane oxygenation (ECMO) preparation under a dural puncture epidural (DPE) technique, and managing the hemodynamic changes that are critical for a congenital heart disease parturient.

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