ISSN: 2578-482X
Authors: Mello MAJ*, Mazza CA and Gabriel EA
The need for cardiac surgery during pregnancy is rare. Only 1% to 4% of pregnancies are complicated by maternal heart disease and most of them can be treated with medical therapy and lifestyle changes. Occasionally, whether due to the natural progression of underlying heart disease or precipitated by cardiovascular changes in pregnancy, cardiac surgical therapy should be considered. Cardiac surgery is inherently dangerous for both mother and fetus with mortality rates close to 10% and 30%, respectively. For some conditions, percutaneous cardiac intervention offers effective therapy with much less risk for the mother and her fetus. For others, cardiac surgery, including procedures that require the use of cardiopulmonary bypass, should be considered to save the mother's life. Given the extreme risks to the fetus, if the patient is in the third trimester, serious consideration should be given to pre-operative delivery involving cardiopulmonary bypass. At earlier gestational ages, when this is not feasible, modifications to the infusion protocol, including higher flow rates, normothermic perfusion, pulsatile flow, and the use of intraoperative monitoring of the external fetal heartbeat should be considered.
Keywords: Cardiac surgical procedures; Cardiopulmonary bypass; Heart defects congenital; Complications of pregnancy;Cardiovascular; Surgery; Pregnancy
