Anesthetic Management of Parturient with Takayasu’s Arteritis – A Series of Three Cases

Abstract

Takayasu’s arteritis (TA), also known as Pulseless disease, Aortic arch syndrome, Occlusive thromboaortopathy, or Aortoarteritis, is an inflammatory pan-endarteritis leading to thrombotic occlusion and aneurysm of major arteries. Major challenges for anesthesia in patients with TA involve severe uncontrolled hypertension, end-organ dysfunction, stenosis of major blood vessels, and difficulties in monitoring arterial blood pressure (BP). The cardiovascular complications attributed to the disease can be seriously enhanced during pregnancy. This case series describes the successful anesthetic management of three cases of TA presenting for lower segment cesarean section (LSCS). Each parturient had a unique presentation, necessitating a specific strategy. A sequential combined spinal epidural is an attractive option; however, each case requires thorough evaluation and appropriate management.

Keywords

• general anesthesia
• parturient
• sequential combined spinal epidural
• takayasu’s arteritis