Low Dose Combined Spinal-Epidural Anesthesia: An Anesthesia Technique for Cesarean Section in a Patient Suffering from Congenitally Corrected Transposition of Great Arteries and Severe Pulmonary Stenosis

A primigravida, aged 22 years, at 39th gestational week was hospitalized with dyspnea since onset of labor. On systemic evaluation and echocardiography, she was diagnosed to have congenitally corrected transposition of the great arteries (CCTGA) along with severe pulmonic stenosis and bidirectional ventricular and atrial septal defects. A multidisciplinary team provided initial symptomatic management, stratified the risk and planned for a cesarean section. A low-dose combined sequential spinal-epidural anesthesia with invasive monitoring was used which provided excellent surgical condition with stable intraoperative and postoperative hemodynamics.