Cardiac Surgery during Pregnancy—Our Experience
Cardiac Surgery during Pregnancy—Our Experience作者机构：Department of Surgery Chirayu Medical College and Hospital Bhopal India Department of Obstetrics and Gynecology Chirayu Medical College and Hospital Bhopal India Department of Anesthesia Chirayu Medical College and Hospital Bhopal India Department of Community Medicine Chirayu Medical College and Hospital Bhopal India
出 版 物：《World Journal of Cardiovascular Surgery》 (心血管外科国际期刊（英文）)
年 卷 期：2017年第7卷第8期
页 面：103-109页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Cardiac Surgery Cardiopulmonary Bypass Fetal Outcome Maternal Outcome Pregnancy
摘 要：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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