Key result
General anesthesia and TEE successfully guide perioperative management of a parturient with uncorrected pentalogy of Fallot.
Why the study?
Few patients with uncorrected pentalogy of Fallot survive to childbearing age, and pregnancy, delivery, and anaesthesia can cause haemodynamic instability, right-to-left shunting, and worsened hypoxaemia.
Case Report (n=1)
General anaesthesia with transoesophageal echocardiography monitoring can be successfully used for caesarean section in high-risk obstetric patients with uncorrected pentalogy of Fallot.
Answers are grounded in this paper and cite their sources.
May support TEE-guided anaesthesia in uncorrected pentalogy of Fallot parturients; hypothesis-generating and should not change practice.
Pentalogy of Fallot is a rare congenital cyanotic heart disease; few patients with uncorrected disease survive to childbearing age. Cardiovascular changes during pregnancy and delivery can lead to haemodynamic instability, while anaesthesia can cause right-to-left shunting and worsen hypoxaemia.We present the learning points from the anaesthetic management of an obstetric patient with uncorrected pentalogy of Fallot. We describe the successful application of general anaesthesia, choice of transoesophageal echocardiography for real-time haemodynamic monitoring and management, and the comprehensive multidisciplinary care of this high cardiovascular risk obstetric patient perioperatively. We also review the literature and discuss the anaesthetic management of patients with pentalogy of Fallot going for caesarean section.
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Leong et al. (2023) conducted a case report in Uncorrected pentalogy of Fallot in pregnancy (n=1). General anaesthesia and transoesophageal echocardiography was evaluated. General anaesthesia and transoesophageal echocardiography for real-time haemodynamic monitoring were successfully applied in the perioperative management of a parturient with uncorrected pentalogy of Fallot.
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