Abstract
BackgroundThe anesthetic management of cesarean sections in Fontan-palliated parturients requires strict hemodynamic control. However, patient management with central venous oxygen saturation (ScvO2) and oxygen consumption (VO2) has never been reported.Case presentationA 30-year-old woman, who had received a total cavopulmonary connection for tricuspid atresia, was planned to undergo cesarean section at 38 weeks’ gestation. During combined spinal-epidural anesthesia, ScvO2 in addition to arterial pressure-based cardiac output (APCO) and central venous pressure (CVP) was monitored, and the change of VO2 was evaluated. After delivery, her APCO was almost unchanged. However, her ScvO2 increased dramatically from 42.1 to 67.3% and her CVP increased from 9 to 11 mm Hg. The calculated mean maternal VO2 changed from 443 to 295 mL/min.ConclusionsIn a cesarean section for a Fontan-palliated parturient, ScvO2 dramatically increased and maternal VO2 decreased by more than 25% after delivery.
Highlights
The anesthetic management of cesarean sections in Fontan-palliated parturients requires strict hemodynamic control
We present the first case of a cesarean section during which Central venous oxygen saturation (ScvO2), arterial pressurebased cardiac output (APCO), and central venous pressure (CVP) were monitored in a patient with Fontan circulation
Our report will contribute to the understanding of the hemodynamic and Oxygen consumption (VO2) changes that occur during cesarean delivery in patients with Fontan circulation
Summary
In a cesarean section for a Fontan-palliated parturient, ScvO2 dramatically increased and maternal VO2 decreased by more than 25% after delivery.
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