Key result
Epidural anesthesia with invasive monitoring maintains hemodynamic stability in a pregnant patient with Ebstein's anomaly.
Why the study?
Ebstein anomaly is a rare congenital heart defect presenting significant perioperative challenges, especially in pregnant patients undergoing caesarean section due to risks of arrhythmias and right-sided heart failure.
Case Report (n=1)
Epidural anaesthesia with invasive monitoring and careful fluid management can be safely used for caesarean section in patients with Ebstein's anomaly.
Supports epidural feasibility in Ebstein's anomaly pregnancy; leaves open need for larger studies before practice change.
Ebstein's anomaly is a rare congenital heart anomaly which poses significant perioperative challenges, particularly in pregnant patients undergoing caesarean section. The condition is marked by apical displacement of the tricuspid valve, causing right atrial enlargement, severe tricuspid regurgitation and an increased risk of arrhythmias and right-sided heart failure.We describe a case of a woman in her 20s with Ebstein's anomaly and severe tricuspid regurgitation who underwent an elective lower-segment caesarean section under epidural anaesthesia. Intraoperative management focused on maintaining haemodynamic stability through invasive monitoring, controlled epidural dosing and judicious fluid administration. The patient remained stable throughout surgery and had an uneventful recovery.This case underscores the need for a multidisciplinary approach, individualised anaesthetic strategies and vigilant perioperative monitoring to ensure safe maternal and fetal outcomes in high-risk cardiac pregnancies.
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Kumar et al. (2025) conducted a case report in Ebstein's anomaly and severe tricuspid regurgitation in pregnancy (n=1). Epidural anaesthesia and perioperative management (invasive monitoring, controlled epidural dosing, judicious fluid administration) was evaluated on Haemodynamic stability and recovery. Epidural anaesthesia with invasive monitoring and judicious fluid administration maintained haemodynamic stability and resulted in an uneventful recovery for a pregnant woman with Ebstein's anomaly.
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