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Med J Bakirkoy. 2011; 7(2): 71-74


Anesthetic management of a pregnant with Takayasu arteritis

Dilek Altun, Gülay Eren, Zafer Çukurova, Halil Çetingök, Yaser Pektaş, Evrim Kucur, Oya Hergünsel.

Abstract
Takayasu’s arteritis (TA) is an idiopathic, rare vasculitis that affects the aorta and its primary branches. It is also known as ‘pulseless disease’ because of its presentation with absence of peripheral pulses. Women are more often affected than men. Anesthesia for patients with Takayasu’s arteritis is complicated by their severe uncontrolled hypertension, end-organ dysfunction resulting from hypertension, stenosis of major blood vessels affecting regional circulation, and difficulties encountered in monitoring arterial blood pressure. Anesthetic management of patients with this disease have been limited to isolated case reports in the anesthetic literature, mostly in women undergoing cesarean delivery. This case has been presented in order to review the details of the disease, since Takayasu’s arteritis has been observed very rarely, and to examine the patients in detail, in order to choose the optimal anesthetic management with the measures to prevent its possible perioperative complications.

Key words: Takayasu arteritis, pregnancy, anaesthesia, complications



Takayasu arteritli bir gebenin anestezik yönetimi

Özet
Takayasu arteriti (TA) idyopatik, daha çok aortik arkın dallarını tutan tıkayıcı bir poliarterittir. TA aynı zamanda periferik nabızların alınamaması ile karakterize olduğundan ‘nabızsızlık hastalığı’ olarak da bilinmektedir. Genç kadınlarda daha fazladır. TA’de anestezi kontrol edilemeyen ciddi hipertansiyon, hipertansiyona bağlı son organ hasarı, genel dolaşımı etkileyen majör damarlardaki tıkanıklık nedeniyle oldukça karmaşıktır.
Takayasu arteritli hastaların anestezi yönetimi ile ilgili bilgiler literatürde, çoğunlukla sezaryen seksiyo vakaları olmak üzere, izole olgu sunumları ile sınırlıdır. Bu olgu, Takayasu arteriti nadir görüldüğünden gözden kaçabilecek detayların yeniden incelenmesi, preoperatif hastaların ayrıntılı değerlendirilmesi, peroperatif ve postoperatif olası komplikasyonların önlenmesi ve en uygun anestezi yönetiminin seçilmesi bakımından hatırlatıcı olarak sunulmuştur.

Anahtar Kelimeler: Takayasu arteriti, gebelik, anestezi, komplikasyonlar



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