World Journal of Cardiovascular Surgery

Volume 7, Issue 8 (August 2017)

ISSN Print: 2164-3202   ISSN Online: 2164-3210

Google-based Impact Factor: 0.19  Citations  

Cardiac Surgery during Pregnancy—Our Experience

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DOI: 10.4236/wjcs.2017.78012    927 Downloads   1,884 Views  

ABSTRACT

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/m2 (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.

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Kanhere, V. , Kanhere, A. , Chakravarty, D. , Pendse, N. , Pendse, M. , Khan, M. , Shrivastava, A. and Narkhede, V. (2017) Cardiac Surgery during Pregnancy—Our Experience. World Journal of Cardiovascular Surgery, 7, 103-109. doi: 10.4236/wjcs.2017.78012.

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