Cardiopulmonary Bypass in Pregnancy

Pomini, Francesco; Mercogliano, Domenico; Cavalletti, Cristina; Caruso, Alessandro; Pomini, P

doi:10.1097/00006254-199608000-00003

Cited by 17 publications

(27 citation statements)

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“…The major risks during pregnancy are atrial fibrillation, embolic events, and pulmonary edema. 5 Without intervention, the maternal mortality for patients with severe mitral stenosis, who are in NYHA class I and II, is 0 to 4% and is significantly higher at 6 to 8% for those in NYHA class III and IV. When the normal mitral valve orifice area of 4 to 6 cm 2 is progressively reduced to 2 cm 2 , the classical symptoms of mitral heart disease start appearing.…”

Section: Discussionmentioning

confidence: 99%

Successful Percutaneous Mitral Valve Balloon Valvuloplasty during Third Trimester

Sree¹,

Mamatha²,

Manoli³

2017

Journal of South Asian Federation of Obstetrics and Gynaecology

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Rheumatic mitral stenosis is the most common acquired valvular lesion in pregnant women. The overall mortality is 1%, but can go up to 5% in those patients with New York Heart Association class III and IV symptoms. Percutaneous mitral balloon valvuloplasty (PMBV) is the procedure of choice in the treatment of rheumatic mitral stenosis. The PMBV is usually done in the first or second trimester, but in the third trimester, PMBV is a less common procedure.A 24-year-old gravida 2 para 1 living 1 with 35 weeks of gestation with previous lower segment cesarean section (LSCS) presented with breathlessness and swelling of lower limbs. Evaluation revealed rheumatic mitral stenosis of moderate severity with moderate mitral regurgitation with cardiac failure. Hence, PMBV was done, which resulted in increase of mitral valve area from 0.6 to 1.7 cm 2 . She had marked symptomatic improvement, and cesarean section was done at 36 weeks 5 days for previous LSCS with preterm premature rupture of membranes. The postoperative period was uneventful.Our report reinforces the fact that third trimester PMBV is safe and effective during pregnancy with no untoward effect on the fetus.

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Section: Discussionmentioning

confidence: 99%

Successful Percutaneous Mitral Valve Balloon Valvuloplasty during Third Trimester

Sree¹,

Mamatha²,

Manoli³

2017

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…4,5 Therefore, in patients with Marfan syndrome planning to have children, elective surgical repair of an ascending aortic aneurysm must be seen as a first-line strategy. 6,7 Herein, we report a case of a 38-yr-old woman with Marfan syndrome with a known aneurysm of the ascending aorta who developed a type A dissection in the 34 th week of gestation. In accordance with our institutional guidelines, the patient gave written informed consent for the publication of this report.…”

Section: Résumémentioning

confidence: 99%

Type A aortic dissection during late pregnancy in a patient with Marfan syndrome

Haas

Trepte

Rybczynski

et al. 2011

Can J Anesth/J Can Anesth

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Purpose To report the management of a 38-yr-old patient with known Marfan syndrome who presented with acute Stanford type A dissection of the aorta in the 34 th week of pregnancy. Clinical features A Cesarean delivery was performed under deep general anesthesia with high-dose opioid administration to avoid tachycardia and hypertension during tracheal intubation and obstetric surgery. Delivery took place less than five minutes after induction of anesthesia, and tracheal intubation of the newborn was required due to opioid-induced hypoventilation. Subsequently, aortic arch repair was performed in the mother after connection to extracorporal bypass. Despite extensive replacement of coagulation factors, severe vaginal bleeding persisted after weaning from extracorporal bypass, and the bleeding stopped only after a hysterectomy was performed. Postoperatively, after a short period in the intensive care unit, mother and child were discharged from hospital in excellent condition ten days after surgery. Conclusion Deep general anesthesia for emergency Cesarean delivery while accepting the risk of respiratory depression in the newborn is a viable option for the anesthetic management of life-threatening events such as Stanford type A dissection.

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“…Successful surgery during gestation or shortly after delivery has been described in a number of women for a marked dilatation of the aorta and for AoD (14,18,21,48,61,83). Because of the increased fetal loss associated with cardiac surgery during pregnancy (9,18,48,61,(83)(84)(85), a C-section should be done before or concomitantly with thoracic surgery in cases where fetal maturity can be confirmed (17,18,59). Termination of pregnancy should be considered when AoD occurs early taking in account a significant risk of fetal complication and loss (48).…”

Section: Surgery For Aortic Complication During Pregnancymentioning

confidence: 99%

Pregnancy and Marfan syndrome

Goland¹,

Elkayam²

2017

Ann. Cardiothorac. Surg.

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Pregnancy in women with Marfan syndrome (MFS) presents challenges to the clinician and the patient due to the increased incidence of maternal complications and involvement of the fetus, and deserves special consideration. The leading cause of morbidity and mortality in MFS is aortic dissection. This article presents an extensive review of available clinical information and provides recommendations for the management of patients with MFS during pregnancy.

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Cardiopulmonary Bypass in Pregnancy

Cited by 17 publications

References 0 publications

Successful Percutaneous Mitral Valve Balloon Valvuloplasty during Third Trimester

Successful Percutaneous Mitral Valve Balloon Valvuloplasty during Third Trimester

Type A aortic dissection during late pregnancy in a patient with Marfan syndrome

Pregnancy and Marfan syndrome

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