Document Detail

Cardiac surgery during pregnancy.
MedLine Citation:
PMID:  17044375     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM OF THE STUDY: Cardiac surgery during pregnancy represents a major challenge as it comprises a single operation for two survivors. METHODS: Between 1988 and 2005, 16 pregnant women underwent cardiac surgery at the authors' institution. Among 14 patients with rheumatic mitral stenosis operated on due to clinical deterioration, closed mitral valvulotomy was performed in 12 cases (three urgently in the third trimester, nine at term concomitantly with cesarean delivery). Two patients underwent mitral valve replacement, again, concomitantly with cesarean delivery at term, while two others underwent emergency reoperation for mechanical valve thrombosis during the second trimester, using a strategy of high-flow, high-pressure perfusion with mild hypothermia. RESULTS: A total of 12 closed mitral valvulotomies and four mitral valve replacements was performed. There was no maternal mortality, and only one stillborn occurred in the urgent closed valvulotomy group. The remaining 15 babies were born healthy. CONCLUSION: In addition to protective perinatal procedures, instances occur during pregnancy when urgent or emergency surgery becomes unavoidable due to life-threatening cardiac decompensation. In patients with mitral stenosis, which is the case in most scenarios, closed mitral valvulotomy is life-saving and offers low fetomaternal risk, as a viable, efficient and practical alternative to percutaneous mitral balloon commissurotomy. When cardiopulmonary bypass (CPB) becomes mandatory, the shortest possible periods of mildly hypothermic or normothermic CPB with a strategy of high flow-high pressure perfusion should be followed.
Zafer H Iscan; Levent Mavioglu; Kerem M Vural; Seref Kucuker; Levent Birincioglu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  15     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-10-18     Completed Date:  2007-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  686-90     Citation Subset:  IM    
Department of Cardiovascular Surgery, Yuksek Ihtisas Hospital of Turkey, Ankara, Turkey.
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MeSH Terms
Cardiopulmonary Bypass
Heart Valve Prosthesis Implantation*
Mitral Valve Stenosis / etiology,  surgery*
Pregnancy Complications, Cardiovascular / surgery*
Pregnancy Outcome
Pregnancy Trimesters
Rheumatic Heart Disease / complications*,  surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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