Anest. intenziv. Med. 2014;25(5):355-359

Perioperative management of Caesarean Section in a parturient with Marfan syndrome - case report and systemic review of literatureAnaesthesiology - Case Reports

Axmann Karel1, Adamus Milan1,2,*
1 Klinika anesteziologie resuscitace a intenzivní medicíny, Fakultní nemocnice Olomouc
2 Lékařská fakulta Univerzity Palackého v Olomouci

Marfan syndrome is an inherited disease affecting mainly the cardiovascular, respiratory and muskuloskeletal systems. Aortic dilatation and dissection is the major cardiovascular complication associated with high mortality. Pregnancy and peripartum are a critical period accelerating the risk of acute aortic dissection. Peripartum management of patients with Marfan syndrome represents a special complex multidisciplinary issue. Due to the rare diagnosis and small patient population, the clinical experience is limited even in specialized centers. Up-to-date literary resources regarding paripartum care of patients with Marfan syndrome are also scarce. We present a case-report of an 18-year old partiturient with the diagnosis of Marfan syndrome who underwent uncomplicated Caesarean Section in regional anaesthesia in the 34th gestational week. Systematic literature review is included, analyzing the recent available papers on anaesthesia for Casarean Section in patients with Marfan syndrome.

Keywords: Marfan syndrome; pregnancy; Caesarean Section; anaesthesia

Received: April 14, 2014; Accepted: July 2, 2014; Published: October 1, 2014  Show citation

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Axmann K, Adamus M. Perioperative management of Caesarean Section in a parturient with Marfan syndrome - case report and systemic review of literature. Anest. intenziv. Med. 2014;25(5):355-359.
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    References

    1. Paterick, T. E., Humphries, J. A., Ammar, K. A. et al. Aortopathies: etiologies, genetics, differential diagnosis, progno-sis and management. Am. J. Med., 2013, 126, 8, p. 670-678. Go to original source... Go to PubMed...
    2. Houston, L., Sullivan, S. Marfan syndrome and vascular dissections during pregnancy, Minerva Gynecol., 2012, 64, 5, p. 409-419.
    3. Regitz-Zagrosek, V., Blomstrom Lundqvist, C. et al. ESC guide-lines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology. Eur. Heart J., 2011, 32, p. 3147-3197.
    4. Adam, H., Radow, L. Anesthesia for section caesarean with aortic dissection in Marfan Syndrome. Anasthesiol Intensivmed Notfallmed Schmerzther, 2002, 37, p. 630-635. Go to original source... Go to PubMed...
    5. Ben Letaifa, D., Slama, A., Methamem, M., Ben Jazia, K., Jegham, H. Anesthesia for cesarean section in a Marfan patient with complicated aortic dissection. Ann. Fr. Anesth. Reanim., 2002, 21, 8, p. 672-675. Go to original source... Go to PubMed...
    6. Brar, H. B. Anaesthetic management of a caesarean section in a patient with Marfan's syndrome and aortic dissection. Anaesth. Intensive Care, 2001, 29, p. 67-70. Go to original source... Go to PubMed...
    7. Chang, C. Y., Yang, J. M., Lam, C. W., Chen, P. H. Successful management of aortic dissection in a patient with Marfan syndrome during pregnancy. Am. J. Obstet. Gynecol., 2013, 208, p. 3-6. Go to original source... Go to PubMed...
    8. Kamata, K., Morioka, N., Nomura, M., Ozaki, M. Short-acting beta 1-adrenergic blocker is useful for anesthetic management of cesarean section in a patient with Marfan syndrome, Masui, 2004, 53, 3, p. 298-2301. Go to PubMed...
    9. Kim, G., Ko, J. S., Choi, D. H. Epidural anesthesia for cesa-rean section in a patient with Marfan syndrome and dural ectasia - A case report. Korean J. Anesthesiol., 2011, 60, 3, p. 214-216. Go to original source... Go to PubMed...
    10. Miyawaki, Y., Yumiba, T., Asaga, T., Taie, S., Shirakami, G. Remifentanil is useful for cardiovascular stability during cesarean delivery in a parturient with Marfan's syndrome. Masui, 2010, 59, 10, p. 1305-1307. Go to PubMed...
    11. Saeki, N., Taguchi, S., Kawamoto, M. Successful management of a patient with Marfan syndrome complicated with acute aortic dissection using landiolol during Cesarean section. J. Anesth., 2010, 24, p. 277-279. Go to original source... Go to PubMed...
    12. Singh, S. I., Brooks, C., Dobkowski, W. General anesthesia using remifentanil for Cesarean delivery in a parturient with Marfan's syndrome. Can. J. Anaesth., 2008, 55, 8, p. 526-531. Go to original source... Go to PubMed...
    13. Tritapepe, L., Voci, P., Pinto, G., Brauneis, S., Menichetti, A. Anaesthesia for caesarean section in a Marfan patient with recur-rent aortic dissection. Can. J. Anaesth., 1996, 43, 11, p. 1153-1155. Go to original source... Go to PubMed...
    14. Abecassis, P., Lecinq, A., Roger-Christoph, S., Mercier, F. J.,Benhamou, D. Management of delivery in patients with Marfan's syndrome presenting aortic dilatation. J. Gynecol. Obstet. Biol. Reprod., 2004, 33, 5, p. 416-420. Go to original source... Go to PubMed...
    15. Allyn, J., Guglielminotti, J., Omnes, S. et al. Marfan's syndrome during pregnancy: anesthetic management of delivery in 16 consecutive patients. Anesth. Analg., 2013, 116, p. 392-398. Go to original source... Go to PubMed...
    16. Handa, F., Ohnishi, Y., Takauchi, Y., Kuro, M. Anesthetic management of parturients with Marfan syndrome. Masui, 2001, 50, p. 399-404. Go to PubMed...
    17. Lacassie, H. J., Millar, S., Leithe, L. G. et al. Dural ectasia: a likely cause of inadequate spinal anaesthesia in two parturients with Marfan's syndrome, Br. J. Anaesth., 2005, 94, 4, p. 500-504. Go to original source... Go to PubMed...
    18. Baghirzada, L., Krings, T., Carvalho, J. C. Regional anesthesia in Marfan syndrome, not all dural ectasias are the same: a report of two cases. Can. J. Anaesth., 2012, 59, 11, p. 1052-1057. Go to original source... Go to PubMed...
    19. Tritapepe, L., Voci, P., Pinto, G., Brauneis, S., Menichetti, A. Anaesthesia for caesarean section in a Marfan patient with recur-rent aortic dissection. Can. J. Anaesth., 1996, 43, 11, p. 1153-1155. Go to original source... Go to PubMed...
    20. Milewicz, D. M., Dietz, H. C., Miller, D. C. Treatment of aortic disease in patients with Marfan syndrome. Circulation, 2005, 111, 11, p. 150-157. Go to original source... Go to PubMed...

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