Heart surgery during pregnancy. From the authors’ clinical practice

• Bazylev V.V.
• Evdokimov M.E.
• Pantyuhina M.A.

Abstract

Aim. To study the results of cardiac interventions with cardiopulmonary bypass during pregnancy.

Material and methods. The article presents a single-center retrospective study of the treatment and outcomes of 19 pregnant patients who underwent 11 open heart surgical procedures with cardiopulmonary bypass, 7 interventional and 1 X-ray procedure endovascular intervention in the period from 2008 to 2023. The average age of the patients was 30 years (20–39 years).

Results. 7 interventional (3 pacemaker implantations, 3 pacemaker reimplantations, 1 radiofreguency ablation of the left anterior BPH), 1 X-ray endovascular intervention (balloon angioplasty of valvular pulmonary artery stenosis with balloon catheters Tyshak II 25–40 mm, Tyshak II 25–60 mm) and 11 open heart open heart interventions with cardiopulmonary bypass were performed: six interventions mitral valve surgery (MVP) and four combined operations on the aortic valve (AK) and ascending aorta. Four of them were repeated. Duration of CBP time was 93.4 minutes (58–166 min), the average aortic cross clump time was 71 minutes (42–142 min). Eight women, simultaneously with cardiac surgery, were pre-delivered by caesarean section. The newborns were transferred to a team of neonatologists and transferred to a specialized hospital for nursing. Three cases of prolongation of pregnancy ended with emergency delivery, planned cesarean section. Maternal and infant mortality were absent.

Conclusion. The observations indicate the possibility of successful cardiac open heart surgery with cardiopulmonary bypass in pregnant women, based on a multidisciplinary approach, without negative consequences for the mother and fetus.

Keywords: cardiopulmonary bypass; pregnancy

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