Successful use of extracorporeal membrane oxygenation during cesarean section in parturients with symptomatic severe pulmonary stenosis: a case report

Optimizing anesthetic management during cesarean section in parturients with severe pulmonary stenosis is difficult. This report describes the use of extracorporeal membrane oxygenation (ECMO) in a patient with symptomatic severe pulmonary stenosis undergoing cesarean section. A 33-year-old primigravid woman was admitted to the emergency department during the 37th week of gestation for vaginal leakage and dyspnea on exertion. Transthoracic echocardiography showed severe pulmonary valve stenosis with a maximal gradient of 135 mmHg, combined with right ventricular hypertrophy and moderately decreased right ventricular contractility. She underwent emergency cesarean section under general anesthesia with ECMO as an adjuvant anesthetic method. Hemodynamic variables were well-maintained in the perioperative period, and the baby was delivered without complications. The patient was successfully weaned off of the ECMO device 3 hours after the end of the operation. The mother and baby were discharged in good health on hospital day 6. General anesthesia with ECMO support can be safe and effective in patients with severe pulmonary stenosis undergoing cesarean section.