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Cardiac Surgery during pregnancy

Cardiac Surgery during pregnancy
Cardiac Surgery during pregnancy
Cardiovascular adaptations during pregnancy are normally well tolerated in healthy women. However, 2% to 4% of women of childbearing age have some degree of concomitant heart disease, and these changes may compromise cardiac function. Of these, a few who do not respond to medical treatment may require surgical correction. In this setting, maternal mortality rate has improved to levels similar to those in non-pregnant counterparts. However, the fetal mortality rate remains high (up to 33%). Factors contributing to high fetal mortality rates include the timing of the operation, the urgency of the operation, and the fetal/fetoplacental response to cardiopulmonary bypass. Modulation of the fetoplacental response to cardiopulmonary bypass may prevent placental dysfunction and sustained uterine contractions, which underlie fetal hypoxia and acidosis.
In this article, we review cardiovascular adaptations to pregnancy and the pathophysiologic effects of cardiopulmonary bypass on the mother, fetus, and fetoplacental unit, and we talk about whether manipulation of these responses can help in improving fetal outcome. Finally, approaches regarding perfusion management and off-pump cardiac surgical techniques in pregnancy are discussed.
cardiac surgical procedures, cardiopulmonary bypass adverse effects, female, heart defects, congenital, pregnancy complications, cardiovascular, etiology, surgery
0730-2347
307-312
Asopa, Sanjay
93ed2a4d-de83-4321-9382-a68d39a33e34
Patel, Anish
1d9baa44-129e-4b01-9886-dab09feb8deb
Tang, Augustine T.M.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
Asopa, Sanjay
93ed2a4d-de83-4321-9382-a68d39a33e34
Patel, Anish
1d9baa44-129e-4b01-9886-dab09feb8deb
Tang, Augustine T.M.
8aa5698c-78cf-4f59-a5af-5afa46f0348c

Asopa, Sanjay, Patel, Anish and Tang, Augustine T.M. (2008) Cardiac Surgery during pregnancy. Texas Heart Institute Journal, 35 (3), 307-312.

Record type: Article

Abstract

Cardiovascular adaptations during pregnancy are normally well tolerated in healthy women. However, 2% to 4% of women of childbearing age have some degree of concomitant heart disease, and these changes may compromise cardiac function. Of these, a few who do not respond to medical treatment may require surgical correction. In this setting, maternal mortality rate has improved to levels similar to those in non-pregnant counterparts. However, the fetal mortality rate remains high (up to 33%). Factors contributing to high fetal mortality rates include the timing of the operation, the urgency of the operation, and the fetal/fetoplacental response to cardiopulmonary bypass. Modulation of the fetoplacental response to cardiopulmonary bypass may prevent placental dysfunction and sustained uterine contractions, which underlie fetal hypoxia and acidosis.
In this article, we review cardiovascular adaptations to pregnancy and the pathophysiologic effects of cardiopulmonary bypass on the mother, fetus, and fetoplacental unit, and we talk about whether manipulation of these responses can help in improving fetal outcome. Finally, approaches regarding perfusion management and off-pump cardiac surgical techniques in pregnancy are discussed.

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More information

Published date: 2008
Keywords: cardiac surgical procedures, cardiopulmonary bypass adverse effects, female, heart defects, congenital, pregnancy complications, cardiovascular, etiology, surgery

Identifiers

Local EPrints ID: 70273
URI: https://eprints.soton.ac.uk/id/eprint/70273
ISSN: 0730-2347
PURE UUID: 240b1481-a2af-4d3a-bbfa-40f551ba0236

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Date deposited: 04 Mar 2010
Last modified: 19 Jul 2019 23:46

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Contributors

Author: Sanjay Asopa
Author: Anish Patel
Author: Augustine T.M. Tang

University divisions

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