Risk factors associated with cardiac surgery during pregnancy

Arnoni, Renato Tambellini; Arnoni, Antoninho S; Bonini, Rômulo César Arnal; Almeida, Antonio Flávio Sanchez de; Neto, Camilo Abdulmassih; Dinkhuysen, Jarbas J; Issa, Mário; Chaccur, Paulo; Paulista, Paulo P

doi:10.1016/s0003-4975(03)01188-3

Cited by 118 publications

(91 citation statements)

References 14 publications

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“…All our patients were NYHA class IV with progressive hemodynamic and res-V. M. Kanhere et al piratory deterioration, despite medical treatment, same observation was seen in a study by Arnoni et al [5].…”

Section: Discussionsupporting

confidence: 85%

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Cardiac Surgery during Pregnancy—Our Experience

Kanhere¹,

Kanhere²,

Chakravarty³

et al. 2017

WJCS

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Background: Rheumatic heart disease (RHD) continues to be endemic in developing countries like India, thus a number of female patient present with valvular heart disease complicating pregnancy. Surgery is lifesaving in patients who are symptomatic on medical management. Objective: To study maternal and fetal outcome in patient's refractory to medical treatment undergoing cardiac surgery during pregnancy. Methodology: Analysis of 8 pregnant patients who underwent cardiac surgery during 5 years from Jan 2012 to Dec 2016 in a Medical college setup in Central India. Results: Maternal age ranged between 20 -35 mean of 23.75, NYHA class IV, refractory to medical treatment. The underlying cardiac lesion was rheumatic heart disease 7 (87.5%) cases, 6 (85.7%) had mitral valve lesion. 7 primigravida (87.5%) patients were taken as elective procedure in second trimester (18 -26 weeks), one multipara patient as emergency after failed Balloon mitral valvuloplasty (BMV) in third trimester of pregnancy (32 weeks) was the only maternal death. 5 (62.5%) patients progressed to term pregnancy and delivered vaginally. The cardiopulmonary bypass variables studied were Median bypass time 51.25 minutes (range 37 -78), median cross-clamp time 25.62 minutes (range 16 -48), Median flow rate 2.4 l/min/m 2 (range 2.2 -2.6) mean perfusion pressure during CPB 65 -89 (range 55 -120) and median perfusate temperature 37˚C (range 32 -38). 2 (29%) patients had a long term follow-up and have delivered at term in their next pregnancies at the institute. Conclusion: Cardiac Surgery can be performed during pregnancy in patients' refractory to medical management. The outcome is better with mother than fetus. Multidisciplinary team approach is the strategy for care.How to cite this paper: Kanhere, V.M.,

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Section: Discussionsupporting

confidence: 85%

“…As per the study by Ávila et al [4] the mean gestational age was 20 weeks. The study by Arnoni et al [5] mentions the mean gestational age as 22 weeks.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Surgery during Pregnancy—Our Experience

Kanhere¹,

Kanhere²,

Chakravarty³

et al. 2017

WJCS

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“…Overall cardiac complication rate in our study was 15.62% which is very similar to 13% reported by Siu SC et al 1,2,4,5 In our study 85. 6,7 All the women improved by at least one functional class by surgical intervention, compared to 82% in the Chandigarh study Sawhney H et al 4 Elkayam et al has concluded that, PBMV should be done in severe symptomatic women with MS who do not respond to medical therapy. 8 Preterm labour was seen in 20% in our study.…”

Section: Discussionmentioning

confidence: 97%

Pregnancy outcome in women with heart disease at a tertiary referral teaching center in Northern India

Gahlot

Singh

Pandey

2016

Int J Reprod Contracept Obstet Gynecol

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“…However, cardiac surgery during pregnancy is associated with maternal and fetus mortalities of 8.6% to 18.6%, related to the severity of maternal clinical condition and to the emergency character of the surgery 4 .…”

Section: Discussionmentioning

confidence: 99%

Valvoplastia aórtica por cateter-balão em emergência materno-fetal na adolescência

Ávila¹,

Hajjar²,

Souza³

et al. 2009

Arq. Bras. Cardiol.

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The increase of cardiac output during pregnancy is the cause of heart failure in women with severe aortic valvular stenosis. Percutaneous aortic valvuloplasty has been associated with severe complications and short-term valvar restenosis. This case showed that percutaneous aortic valvuloplasty allowed both mother and fetus to survive after childbirth, and that postpartum treatment interruption resulted in maternal death in late postpartum care.

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Risk factors associated with cardiac surgery during pregnancy

Cited by 118 publications

References 14 publications

Cardiac Surgery during Pregnancy—Our Experience

Cardiac Surgery during Pregnancy—Our Experience

Pregnancy outcome in women with heart disease at a tertiary referral teaching center in Northern India

Valvoplastia aórtica por cateter-balão em emergência materno-fetal na adolescência

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