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Emergency Cesarean Section in a Parturient with Ruptured Sinus of Valsalva Under Spinal Anesthesia: A Case Report

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Specialty General Medicine
Date 2024 Jun 5
PMID 38836072
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Abstract

Ruptured Sinus of Valsalva (RSOV) is a rarely encountered cardiac anomaly that can potentially lead to adverse clinical outcomes. RSOV increases the risk of morbidity during pregnancy due to the physiological changes associated with gestation, that can exacerbate the underlying cardiac pathology. We present the case of a 29-year-old female with an uncorrected RSOV who required an emergency cesarean section for abruptio placenta. The patient underwent the procedure under spinal anesthesia, with careful titration of norepinephrine infusion and close monitoring of hemodynamic parameters using an invasive intra-arterial line. Given the absence of established anesthetic protocols for parturients with RSOV undergoing cesarean delivery, a comprehensive understanding of the complex interaction between the hemodynamic effects of RSOV, pregnancy, and anesthesia is essential. This understanding enables the safe use of spinal anesthesia in urgent situations, leading to favorable patient outcomes.

References
1.
Suwanrath C, Thongphanang P, Pinjaroen S, Suwanugsorn S . Validation of modified World Health Organization classification for pregnant women with heart disease in a tertiary care center in southern Thailand. Int J Womens Health. 2018; 10:47-53. PMC: 5779307. DOI: 10.2147/IJWH.S150767. View

2.
Meng M, Arendt K . Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations. Anesthesiology. 2021; 135(1):164-183. PMC: 8613767. DOI: 10.1097/ALN.0000000000003833. View

3.
Doost A, Craig J, Soh S . Acute rupture of a sinus of Valsalva aneurysm into the right atrium: a case report and a narrative review. BMC Cardiovasc Disord. 2020; 20(1):84. PMC: 7027063. DOI: 10.1186/s12872-020-01383-7. View

4.
Ng K, Parsons J, Cyna A, Middleton P . Spinal versus epidural anaesthesia for caesarean section. Cochrane Database Syst Rev. 2004; (2):CD003765. PMC: 8728877. DOI: 10.1002/14651858.CD003765.pub2. View

5.
Simmons S, Dennis A, Cyna A, Richardson M, Bright M . Combined spinal-epidural versus spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2019; 10:CD008100. PMC: 6786885. DOI: 10.1002/14651858.CD008100.pub2. View