A Historic Case of Cardiac Surgery in Pregnancy

Benlamkaddem, Said; Berdaï, Mohamed Adnane; Labib, Smael; Harandou, Mustapha

doi:10.1155/2016/7518697

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…Normothermia or mild hypothermia (T >35°C) has been shown to improve foetal outcomes 18 . Adequate pump flow (>2.5 L/min/m 2 ), perfusion pressure (>70 mmHg), and haematocrit levels >28% during CPB are recommended for optimal utero-placental perfusion 16 . Our patient had a favourable result following surgery with a healthy live birth and no further cardiac complications.…”

Section: Discussionmentioning

confidence: 70%

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A case report: mechanical tricuspid valve thrombosis necessitating cardiac surgery during pregnancy

Sathananthan

Johal

Grewal

2019

European Heart Journal - Case Reports

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Background Pregnant women with mechanical valves are considered a high-risk pregnancy. They carry an increased risk of both maternal and foetal complications. This includes maternal valve thrombosis, foetal embryopathy, and haemorrhage. Cardiac surgery is generally avoided during pregnancy, and is used when there are no other alternative options. Cardiopulmonary bypass (CPB) during pregnancy is associated with high foetal mortality. Maternal mortality in the setting of CPB however, is not dissimilar to a non-pregnant woman. Case summary We present the case of a 29-year-old woman with Ebstein’s anomaly who developed thrombosis of her mechanical tricuspid valve at 4 weeks’ gestation. This was suspected to be likely due to sub-therapeutic anticoagulation at the time of presentation. She underwent a tricuspid valve replacement during the first trimester of pregnancy after failing medical therapy, with overall favourable maternal and foetal outcomes. Discussion Valve thrombosis during pregnancy is a devastating complication. There is limited data surrounding the best management strategy of valve thrombosis in pregnancy. Cardiac surgery with CPB is reserved for cases refractory to appropriate medical therapy. Though maternal mortality is largely unaffected, foetal mortality with CPB remains high. The management of pregnant women undergoing CPB is unique and extremely challenging. It requires a meticulous, multidisciplinary approach to improve overall outcomes.

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Section: Discussionmentioning

confidence: 70%

“…Surgery in the first trimester is associated with a higher risk of foetal malformations, while surgery in the third trimester is associated with premature delivery and maternal complications. If the foetus is of advanced gestational age (>28 weeks), delivery prior to the CPB should be considered 16 …”

Section: Discussionmentioning

confidence: 99%

A case report: mechanical tricuspid valve thrombosis necessitating cardiac surgery during pregnancy

Sathananthan

Johal

Grewal

2019

European Heart Journal - Case Reports

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Endocarditis in pregnancy and postpartum: cases in a prospective adult cohort and literature review

Oliveira¹,

Fraife²,

Barbosa³

et al. 2022

HVT

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Objective: Pregnancy and postpartum infective endocarditis (PPIE), although uncommon, is a very serious condition. To describe cases of infectious endocarditis (IE) in in a cohort of adults with IE in a Brazilian center and to review data from the recent literature on the subject. Methods: Cases of definite IE by the modified Duke criteria in adults were retrieved in a contemporary cohort of adults with IE from January 2006 to December 2020. Literature review on the topic was carried out and case reports on PPIE from 2014 to 2020 were compiled. Results: Two cases of PPIE were found in 401 adult patients with IE, with a prevalence of 0.5% in the cohort, of 2/139 (1.4%) among women and 2/83 (2.4%) of women of reproductive age (18 -49 years) in this same cohort. The search for published case reports from 2014 to 2020 resulted in 61 episodes of PPIE; in these, 7 pregnant women (11.4%), 10 fetuses (16.4%) and 1 premature newborn (1.6%) died. There was a previous valve predisposition in 12 (19.7%) cases and intravenous drug use in 14(23%). Left-sided valves were the most frequently affected in 41 (67.2%) of the cases. The most common isolated infectious agent was methicillin sensitive Staphylococcus aureus in 18/61 (29.5%) patients, although as a group, oral viridans streptococci accounted for 16/61 (26.2%). Valve surgery was done for 70% of patients. Conclusions: Intravenous drug use remained to be the main risk factor for IE. Mortality remained high for mothers and their children, despite the fact surgery was done more frequently in the recent cases. In the case of fever without an obvious focus in pregnant or post-partum women, the diagnosis of IE must be readily considered, especially in those with prosthesis and/or intravenous drug use.

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Momentary cesarean delivery and mitral valve reprosthetics in 36-year-old primiparous patient (clinical case)

Базылев

Евдокимов

Пантюхина

2019

Medicinskij alfavit

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This clinical case report represents our experience of treatment of 36 y. o. pregnant female patient who was previously undergone mitral valve replacement as she was 25. The operation was performed with the use of two leaflet mechanical prosthesis ‘MedEng No. 21’ (Russia). The patient was admitted to our hospital at 29th week of gestation with the signs of heart failure and pulmonary congestion because of prosthetic valve dysfunction. Delivery was performed by Caesarean section followed by mitral valve reprosthetics. In order to stop obstetric bleeding before heparin injection internal iliac arteries was ligated. Total time of extracorporeal circulation was 89 minutes, and myocardial ischemia — 64 minutes. Normothermic perfusion was performed. Mother and newborn were discharged from the hospital in a normal stable state. The childbearing ability of the mother was preserved.

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A Historic Case of Cardiac Surgery in Pregnancy

Cited by 3 publications

References 13 publications

A case report: mechanical tricuspid valve thrombosis necessitating cardiac surgery during pregnancy

A case report: mechanical tricuspid valve thrombosis necessitating cardiac surgery during pregnancy

Endocarditis in pregnancy and postpartum: cases in a prospective adult cohort and literature review

Momentary cesarean delivery and mitral valve reprosthetics in 36-year-old primiparous patient (clinical case)

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