Perinatal mitral valve interventions: a report of 10 cases

Birincioğlu, Cemal Levent; Küçüker, Şeref Alp; Yapar, Elif Gül; Yildiz, Ülkü; Ulus, A. Tulga; Yamak, Birol; Katırcıoğlu, Salih Fehmi; Taşdemi̇r, Oğuz

doi:10.1016/s0003-4975(99)00234-9

Cited by 15 publications

(5 citation statements)

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“…All had good maternal and fetal outcomes. They concluded that mitral valve intervention combined with cesarean delivery is the best therapeutic option for symptomatic mitral stenotic patients [7].…”

Section: Discussionmentioning

confidence: 99%

Advanced Pregnancies With Valvular Heart Disease Requiring Peripartum Cardiac Intervention: Two Case Reports and Literature Review

Deedwania¹,

Dadhwal²,

Sharma³

2022

Cureus

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Cardiac interventions during advanced gestation carry a risk of maternal complications including mortality, along with the serious threat to the life of a viable fetus. However, with advancements in anesthesia and surgery techniques, cardiac interventions can be performed successfully during the peripartum period. We report two cases of decompensated severe valvular stenosis in the third trimester. One patient underwent balloon valvuloplasty followed by cesarean delivery. However, the other underwent a cesarean delivery followed by double valve replacement. Favorable maternal and fetal outcomes were achieved through peripartum interventions. Good fetomaternal outcomes can be obtained in women with severe valvular heart disease (VHD) presenting late in pregnancy. The decision for the timing of cardiac intervention in relation to cesarean section (CS) can vary from case-to-case basis.

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Section: Discussionmentioning

confidence: 99%

Advanced Pregnancies With Valvular Heart Disease Requiring Peripartum Cardiac Intervention: Two Case Reports and Literature Review

Deedwania¹,

Dadhwal²,

Sharma³

2022

Cureus

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“…Other authors have reported the use of thiopentone for induction which causes hypotension and can worsen tachycardia. [10][11][12] Also, high dose of fentanyl, when used for induction, can lead to severe neonatal respiratory depression. 10 Etomidate, which has no effect on the sympathetic nervous system, was used to avoid hypotension.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia Management of Simultaneous Cesarean Section and Valve Replacement: A Tight-rope Walk Twice!

Basantwani¹,

Tendolkar²,

Jain³

et al. 2018

Journal of Research &Amp; Innovation in Anesthesia

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Background: Rheumatic valvular stenosis is the most common valvular heart disease which is encountered in pregnant patients in our country. Combination of severe mitral or aortic stenosis (AS) and physiological changes that accompany pregnancy amplifies problems.Case report: Two patients with severe rheumatic valve stenosis underwent simultaneous cesarean section (CS) and valve replacement (VR) surgeries. Heart rate (HR) control with diltiazem was required in one patient who was in atrial fibrillation (AF). Anesthesia was induced with etomidate and rocuronium. Cesarean section was performed followed by VR. Conclusion and clinical significance:Management of anesthesia for such cases is a challenge, as there is a risk of worsening cardiac failure at multiple stages, increasing maternal and fetal morbidity and mortality. The conventional high-dose opioid-based anesthesia strategy followed for VR in stenotic lesions may cause neonatal respiratory depression requiring ventilatory support. A tight balance between maintaining maternal hemodynamics, uterine blood flow, and fetal oxygenation is required for good maternal and fetal outcomes.

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“…In addition to these considerations, the safety of cardiopulmonary bypass in pregnancy is questionable, as it carries a higher risk of fetal complications. An approach combining cesarean section and CMV has been described from Turkey [7] for symptomatic but stabilized women with mitral stenosis. The justification for this approach is the avoidance of maternal and perinatal morbidity during labor and the postpartum period, which arise from hemodynamic alterations in unoperated women.…”

Section: Discussionmentioning

confidence: 99%