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Caesarean delivery in a parturient with Holt-Oram syndrome and implantable cardioverter defibrillator: anaesthetic considerations.
[holt-oram syndrome]
Holt-
Oram
syndrome
is
a
rare
autosomal
dominant
disorder
characterized
by
skeletal
upper
-
limb
dysplasias
and
congenital
cardiac
defects
.
Clinical
manifestations
of
this
syndrome
vary
,
and
range
from
sub
clinical
radiologic
findings
to
overt
,
life-threatening
disease
.
The
author
of
this
article
reports
safe
and
effective
use
of
low
dose
sequential
combined
spinal
and
epidural
anaesthesia
for
caesarean
section
in
a
parturient
with
Holt-
Oram
syndrome
and
automatic
implantable
cardioverter
defibrillator
(
AICD
)
.
Concerns
with
regards
to
anaesthetic
management
include
problems
with
vascular
access
,
possible
arrhythmias
,
the
presence
of
an
AICD
,
and
the
possibility
of
cardiovascular
instability
.
The
characteristics
of
this
syndrome
and
anaesthetic
implications
are
discussed
.
