Percutaneous Coronary Intervention in Pregnancy: Modeling of the Fetal Absorbed Dose

Kuba, Kfier; Wolfe, Diana; Schoenfeld, Alan H.; Bortnick, Anna E.

doi:10.1155/2019/8410203

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…The radial artery approach is preferred over femoral to minimize radiation risk and vascular damage near the fetus. 2,11 Femoral access was used in our patient because of the small diameter of her radial artery and potential need of mechanical circulatory support considering she had a left anterior descending artery STEMI in twin pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction in a Patient with Twin Pregnancy: A Case Report

Michaelis

Gunaga

McKechnie

et al. 2021

Clinical Practice and Cases in Emergency Medicine

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Introduction: Acute myocardial infarction (AMI) rarely occurs during pregnancy and presents unique challenges in diagnosis and management. Traditionally, pregnancy has not readily been considered a risk factor for AMI in the emergency department despite the potential for adverse impacts on maternal and fetal health. As cardiovascular risk factors and advanced maternal age become more prevalent in society over time, the incidence will continue to increase. Prior cases with singular gestation have been reported; however, only one previous case during a twin pregnancy was identified in the medical literature. Case Report: We describe a rare case of acute ST-segment elevation myocardial infarction in a 37-year-old woman at 24 weeks gestation with a dichorionic diamniotic twin pregnancy. Conclusion: It is important for the emergency physician to recognize acute coronary syndrome as a part of the differential diagnosis of chest pain in pregnant patients and be familiar with the diagnostic and management options available for this special population.

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Section: Discussionmentioning

confidence: 99%

Acute Myocardial Infarction in a Patient with Twin Pregnancy: A Case Report

Michaelis

Gunaga

McKechnie

et al. 2021

Clinical Practice and Cases in Emergency Medicine

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“…13,73 Other techniques suggested to minimise radiation to the patient include using a lower frame rate (7.5 frames/s), using wedge filters, changing the projection frequently to distribute radiation and opening the iris on the television camera, which allows a lower increase in beam intensity. 74,75…”

Section: Methods To Minimise Radiationmentioning

confidence: 99%

Diagnostic Angiograms and Percutaneous Coronary Interventions in Pregnancy

Khaing

Kunadian

2020

Interv Cardiol

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Cardiovascular disease is the leading indirect cause of maternal mortality in the UK. Pregnancy increases the risk of acute MI (AMI) by three- to fourfold secondary to the profound physiological changes that place an extra burden on the cardiovascular system. AMI is not always recognised in pregnancy and there is concern among both clinicians and patients regarding catheter-based interventions due to fears of foetal irradiation and risks to the foetus. This article evaluates the current state of knowledge on AMI in pregnancy with particular emphasis on pregnancy-associated spontaneous coronary artery dissection and percutaneous coronary intervention as the revascularisation procedure for AMI. Special considerations that must be made in patients requiring percutaneous coronary intervention for pregnancy-associated spontaneous coronary artery dissection and the current recommendations on arterial access, methods of minimising radiation and stent selection are discussed.

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“…As the recommended DAPT duration in DES shortens, however, BMS is likely to fall increasingly out of favor. This is especially true given that DES have been shown to be used safely in pregnancy [ 8 , 42 , 43 ]; the safety and success profile of DES in the non-pregnant patient is favorable when compared to BMS [ 8 , 43 ]. Newer generation DES are also approved by the United States Food and Drug Administration (FDA) for DAPT duration as short as 28 days [ 44 ], which may be advantageous given the potential limitations of DAPT use at the time of peri-delivery anesthesia.…”

Section: Managementmentioning

confidence: 99%

Acute Coronary Syndrome in Pregnancy and the Post-Partum Period

O’Kelly

Ludmir

Wood

2022

JCDD

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Cardiovascular disease is the leading cause of maternal mortality in the United States. Acute coronary syndrome (ACS) is more common in pregnant women than in non-pregnant controls and contributes to the burden of maternal mortality. This review highlights numerous etiologies of chest discomfort during pregnancy, as well as risk factors and causes of ACS during pregnancy. It focuses on the evaluation and management of ACS during pregnancy and the post-partum period, including considerations when deciding between invasive and non-invasive ischemic evaluations. It also focuses specifically on the management of post-myocardial infarction complications, including shock, and outlines the role of mechanical circulatory support, including veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Finally, it offers additional recommendations for navigating delivery in women who experienced pregnancy-associated myocardial infarction and considerations for the post-partum patient who develops ACS.

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Percutaneous Coronary Intervention in Pregnancy: Modeling of the Fetal Absorbed Dose

Cited by 10 publications

References 13 publications

Acute Myocardial Infarction in a Patient with Twin Pregnancy: A Case Report

Acute Myocardial Infarction in a Patient with Twin Pregnancy: A Case Report

Diagnostic Angiograms and Percutaneous Coronary Interventions in Pregnancy

Acute Coronary Syndrome in Pregnancy and the Post-Partum Period

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