A Calculated Approach: Neuraxial Anesthesia in a High-Risk Parturient with Aortic Stenosis
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Description
Neuraxial anesthesia is traditionally avoided in patients with severe aortic stenosis due to the risk of catastrophic hypotension from reduced sympathetic tone, leading to decreased preload, contractility, heart rate, and cardiac output. These challenges are typically better managed under general anesthesia with vasopressor and inotropic support. However, general anesthesia poses unique risks in severely obese patients, including difficult airway management, increased aspiration risk, and impaired respiratory mechanics. In pregnant patients, both maternal and fetal considerations are paramount and the anesthetic approach requires careful planning. This case highlights the successful use of a combined spinal-epidural technique in a parturient with aortic stenosis and class IV obesity, demonstrating how neuraxial anesthesia can be safely performed with meticulous hemodynamic optimization.
Publication Date
5-9-2025
Recommended Citation
Kapp A, Bobba K, Jaklitsch P. A calculated approach: Neuraxial anesthesia in a high-risk parturient with aortic stenosis. Presented at: Research Day Corewell Health West; 2025 May 9; Grand Rapids, MI.
Comments
2025 Research Day Corewell Health West, Grand Rapids, MI, May 9, 2025. Abstract 1788