Ailevi Hiperlipidemili ve Yapay Mitral Kalp Kapakçıklı Gebe Hastada Acil Sezaryen İçin Genel Anestezi Yönetimi
Özet
Kardiyak hastalıklar gebelikte en önemli morbidite ve mortalite nedenleri arasındadır. Hastaların günümüzde erken tanı ve erken medikal/cerrahi tedavilerinin mümkün olması bu vakalarla gebelikte de daha sık karşılaşmamıza neden olmaktadır. Biz bu vakada ailevi hiperlipidemi nedeni ile 3 defa koroner anjiyografi yapılmış, 1 defa açık kalp cerrahisi geçirmiş ve yapay mitral kapağı olan gebenin acil sezaryen operasyonunda genel anestezi yönetimini sunmayı amaçladık.
Cardiac diseases are among the most important causes of morbidity and mortality during pregnancy. Nowadays, the availability of early diagnosis and early medical/surgical treatments for these patients leads to encountering such cases more frequently during pregnancy. In this case, we aimed to present the general anesthesia management during an emergency cesarean section of a pregnant patient with a prosthetic mitral valve who had undergone coronary angiography three times and open-heart surgery once due to familial hyperlipidemia.
Referanslar
Gomar C, Errando CL. Neuroaxial anaesthesia in obstetrical patients with cardiac disease. Curr Opin Anaesthesiol. 2005 Oct;18(5):507-12.
Nemati MH, Astaneh B, Joubeh A. Triple coronary artery bypass graft in a 10-year-old child with familial hypercholesterolemia. Gen Thorac Cardiovasc Surg. 2009 Feb;57(2):94-7.
Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008 Sep 23;52(13):e1-142.
Hiéronimus S, Benlian P, Bayer P, Bongain A, Fredenrich A. Combination of apolipoprotein E2 and lipoprotein lipase heterozygosity causes severe hypertriglyceridemia during pregnancy. Diabetes Metab. 2005 Jun;31(3 Pt 1):295-7.
Goldberg AS, Hegele RA. Severe hypertriglyceridemia in pregnancy. J Clin Endocrinol Metab. 2012 Aug;97(8):2589-96. doi: 10.1210/jc.2012-1250. Civeira F, Castillo S, Alonso R, Meriño-Ibarra E, Cenarro A, Artied M, Martín-Fuentes P, Ros E, Pocoví M, Mata P; Spanish Familial Hypercholesterolemia Group. Tendon xanthomas in familial hypercholesterolemia are associated with cardiovascular risk independently of the low-density lipoprotein receptor gene mutation. Arterioscler Thromb Vasc Biol. 2005 Sep;25(9):1960-5.
Thompson GR; HEART-UK LDL Apheresis Working Group. Recommendations for the use of LDL apheresis. Atherosclerosis. 2008 Jun;198(2):247-55.Basar R, Uzum AK, Canbaz B, Dogansen SC, Kalayoglu-Besisik S, Altay-Dadin S, et al. Therapeutic apheresis for severe hypertriglyceridemia in pregnancy. Arch Gynecol Obstet. 2013 May;287(5):839-43.
Zangrillo A, Landoni G, Pappalardo F, Oppizzi M, Torri G. Different anesthesiological management in two high risk pregnant women with heart failure undergoing emergency cesarean section. Minerva Anestesiol. 2005 May;71(5):227-36.
Hasegawa A, Azuma Y, Ohashi Y, Yamashina M, Moriyama K, Iijima T, Yorozu T. [Anesthetic management of a patient with pulmonary arterial hypertension undergoing caesarean section]. Masui. 2013 Feb;62(2):183-5.
Lenoir B, Freiermuth C, Bonnet A, Marty J. Césarienne, maladie mitrale et hypertension artérielle pulmonaire. Implications du monitorage hémodynamique sur la conduite de l’anesthésie [Cesarean section, mitral valve disease and pulmonary hypertension. Implications of hemodynamic monitoring on anesthetic management]. Ann Fr Anesth Reanim. 1993;12(6):582-6.
Coskun D, Mahli A, Korkmaz S, Demir FS, Inan GK, Erer D, Ozdogan ME. Anaesthesia for caesarean section in the presence of multivalvular heart disease and severe pulmonary hypertension: a case report. Cases J. 2009 Dec 22;2:9383