Author(s)

Vivek Madhav Kanhere¹, Anjali Vivek Kanhere^2*, Devashish Chakravarty³, Nikhil Pendse¹, Milan Pendse³, Munir Ahmed Khan³, Anita Shrivastava², Vinod Narkhede⁴

¹Department of Surgery, Chirayu Medical College and Hospital, Bhopal, India.
²Department of Obstetrics and Gynecology, Chirayu Medical College and Hospital, Bhopal, India.
³Department of Anesthesia, Chirayu Medical College and Hospital, Bhopal, India.
⁴Department of Community Medicine, Chirayu Medical College and Hospital, Bhopal, India.

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.

Cardiac Surgery, Cardiopulmonary Bypass, Fetal Outcome, Maternal Outcome, Pregnancy

Kanhere, V. , Kanhere, A. , Chakravarty, D. , Pendse, N. , Pendse, M. , Khan, M. , Shrivastava, A. and Narkhede, V. (2017) Cardiac Surgery during Pregnancy—Our Experience. World Journal of Cardiovascular Surgery, 7, 103-109. doi: 10.4236/wjcs.2017.78012.