AORTIC-STENOSIS, CESAREAN DELIVERY, AND EPIDURAL-ANESTHESIA

A 23-year-old female was referred to the University of Arkansas for Me dical Sciences at 32 weeks' gestation with a history of aortic stenosi s following aortic valve replacement. Evaluation by echocardiography s howed an approximately 90 mmHg transvalvular pressure gradient. Pregna ncy progressed to 36 weeks' gestation without problem, at which time t he patient underwent cesarean section with lumbar epidural anesthesia. Invasive hemodynamic monitors were used to assess cardiac performance and as a guide for anesthetic management. The impact of aortic stenos is on pregnancy is discussed, as are management aspects of lumbar epid ural anesthesia in such patients.