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Successful use of extracorporeal membrane oxygenation during cesarean section in parturients with symptomatic severe pulmonary stenosis: a case report
Med Biol Sci Eng 2019;2(2):46-50
Published online July 31, 2019
© 2019 Medical Biological Science and Engineering.

Doo-Hwan Kim, Gi-Ho Koh, Sang-A Lee, Young-Kug Kim, Dong-Min Jang

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence to: Dong-Min Jang
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-5308
Fax: +82-2-3010-6790
E-mail: dmjang@amc.seoul.kr
ORCID: https://orcid.org/0000-0002-6254-9467
Received January 10, 2019; Revised April 9, 2019; Accepted April 10, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Optimizing anesthetic management during cesarean section in parturients with severe pulmonary stenosis is difficult. This report describes the use of extracorporeal membrane oxygenation (ECMO) in a patient with symptomatic severe pulmonary stenosis undergoing cesarean section. A 33-year-old primigravid woman was admitted to the emergency department during the 37th week of gestation for vaginal leakage and dyspnea on exertion. Transthoracic echocardiography showed severe pulmonary valve stenosis with a maximal gradient of 135 mmHg, combined with right ventricular hypertrophy and moderately decreased right ventricular contractility. She underwent emergency cesarean section under general anesthesia with ECMO as an adjuvant anesthetic method. Hemodynamic variables were well-maintained in the perioperative period, and the baby was delivered without complications. The patient was successfully weaned off of the ECMO device 3 hours after the end of the operation. The mother and baby were discharged in good health on hospital day 6. General anesthesia with ECMO support can be safe and effective in patients with severe pulmonary stenosis undergoing cesarean section.
Keywords : Cesarean section; Extracorporeal membrane oxygenation; Pregnant woman; Pulmonary valve stenosis; General anesthesia
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