Key result
Dural puncture epidural anaesthesia enables safe delivery in Ebstein anomaly with a prior Glenn shunt.
Why the study?
Parturients with Ebstein anomaly present an anaesthetic challenge, and those palliated with bidirectional Glenn shunts are susceptible to right heart dysfunction from the physiological changes during parturition.
Case Report (n=1)
No
Multidisciplinary planning and neuraxial anesthesia with careful hemodynamic monitoring allowed for safe vaginal delivery in a parturient with Ebstein anomaly and a bidirectional Glenn shunt.
Adds case evidence for dural puncture epidural with planning in Ebstein anomaly; leaves open need for systematic data.
Parturients with Ebstein anomaly are an anaesthetic challenge due to the spectrum of disease. Patients palliated with bidirectional Glenn shunts are susceptible to right heart dysfunction due to the physiological changes during parturition. We present a 28-year-old primigravida with Ebstein anomaly surgically managed by a bidirectional Glenn shunt. Echocardiograms showed normal right ventricular function despite reported dyspnea as the pregnancy progressed. Following a comprehensive plan developed during multidisciplinary prenatal meetings, she safely delivered. In this case report, we discuss the preoperative evaluation, management of labour and delivery, and postpartum planning of parturients with palliated Ebstein anomaly.
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Reddy et al. (2021) conducted a case report in Ebstein anomaly and prior bidirectional Glenn shunt in pregnancy (n=1). Dural puncture epidural anaesthesia and multidisciplinary peripartum management was evaluated on Safe delivery and maternal/fetal outcomes. A 28-year-old parturient with Ebstein anomaly and a prior bidirectional Glenn shunt safely delivered under dural puncture epidural anaesthesia following multidisciplinary peripartum planning.
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