General anesthesia using remifentanil for Cesarean delivery in a parturient with Marfan’s syndrome

Abstract

Peripartum hemodynamic changes can be life-threatening to the parturient with Marfan's syndrome and aortic dilatation. Anesthetic goals for delivery included preparation for possible aortic dissection, and avoidance of increased aortic root shear stress, through careful hemodynamic monitoring, and general anesthesia using remifentanil.

Non-invasive assessment of gestational hemodynamics: benefits and limitations of impedance cardiography versus other techniques

“…obstetric population [47][48][49][50][51]. Regarding the pulse contour analysis, changes in vascular tone may affect the reliability of the signal, rendering this system not useful in pregnancy where vascular tone is highly variable.…”

Anesthesia Management of a Thoracoabdominal Aortic Aneurysms in Marfan Syndrome

“…Multisistemik birçok patolojiyi içeren bu olgular ender de olsa kalp ve aort patolojileri dışında yineleyen inguinal, femoral, herni operasyonları, eklem dislokasyonları (11) , sezaryen (12,13) , oküler ameliyatlar (14) ve akut batın (15) gibi nedenlerle anesteziyologların karşı-sına çıkabilmektedir. Acil olgularda tespit edilmemiş anevrizma varlığı düşünülerek anestezi uygulamasın-da hipertansiyon, hipotansiyon ve taşikardiye neden olmamaya özen göstermek gereklidir.…”

Minimally- and non-invasive assessment of maternal cardiac output: go with the flow!

“…There are many reports in the literature of TOE being routinely used in the diagnosis and management of high-risk cardiac conditions in pregnant women as well as its use in emergency situations such as fulminant cardiomyopathy, pulmonary and amniotic fluid emboli. [23][24][25][26][27][28] Echocardiography, however, is rarely a common skill acquired by obstetric anaesthetists or trainees and is a specialised technique unsuitable for the occasional user in an emergent delivery situation. Additionally it is necessary to not only grasp the technique of echocardiography but also to understand the normal structural and functional changes that occur during pregnancy when interpreting these studies.…”