Case Studies Anaesthesia for caesarean section in a patient with Eisenmenger syndrome

F. Witts-Hewinson, E. Kemp

About the author(s) F. Witts-Hewinson, Department of Anaesthesia, University of the Witwatersrand, South Africa
E. Kemp, Department of Anaesthesia, University of the Witwatersrand, South Africa

Providing anaesthesia for patients presenting with Eisenmenger syndrome remains a daunting prospect, with reports of perioperative mortality rates up to 30%.1,2 No established guidelines exist for the anaesthetic management of these patients. A patient with Eisenmenger syndrome, secondary to an untreated atrioventricular septal defect (AVSD), presented for a caesarean section. A brief description of the patient's presenting conditions, their anaesthetic management, and outcome is discussed. The use of "graded" epidural anaesthesia and nitric oxide (NO) inhalation to decrease pulmonary vascular resistance (PVR) was recorded.

caesarean section; cardiac anaesthesia; epidural anaesthesia; Eisenmenger syndrome; pulmonary hypertension; regional anaesthesia

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