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OBSTETRIC ANESTHESIOLOGY

The Anesthetic Management for Cesarean Delivery in a Patient with Shone's Syndrome

From the Department of Anesthesiology, Georgetown University School of Medicine, Washington, DC.

Address correspondence to Medhat Hannallah, MD, FFARCS, Department of Anesthesia, Georgetown University Hospital, 3800 Reservoir Rd., NW, Washington DC 20007. Address e-mail to hannallm{at}georgetown.edu.

Abstract

Shone's syndrome is a rare congenital cardiac condition that consists of up to four obstructive left-sided cardiac lesions. We report a 17-yr-old nullipara with Shone's syndrome who presented for cesarean delivery. She had mild mitral stenosis and mild left ventricular outflow tract obstruction. Epidural anesthesia was attempted, but the patient developed severe hypotension associated with fetal bradycardia necessitating immediate cesarean delivery under general anesthesia. The peripartum anesthetic and management considerations for these patients are discussed.