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J Thorac Cardiovasc Surg 2003;126:894-895
© 2003 The American Association for Thoracic Surgery

Brief communications

Cardiac surgery during pregnancy: pulsatile or nonpulsatile perfusion?

^a Department of Cardiac Surgery, St George's Hospital and Medical School, London, United Kingdom
^b Department of Anaesthesia,, St George's Hospital and Medical School, London, United Kingdom
^c Department of Fetal Medicine, St George's Hospital and Medical School, London, United Kingdom
^d Department of Cardiology, St George's Hospital and Medical School, London, United Kingdom

Received for publication January 30, 2003; accepted for publication March 24, 2003.

^* Address for reprints: Marjan Jahangiri, FRCS, Department of Cardiac Surgery, St George's Hospital and Medical School, Blackshaw Rd, London SW17, OQT, United Kingdom
marjan.jahangiri@stgeorges.nhs.uk

The first 20% of the full text of this article appears below.

Cardiopulmonary bypass (CPB) during pregnancy is associated with a high fetal and maternal mortality. Contributing factors are timing of the operation, emergency situations, and placental vasoconstriction. Experimental evidence suggests that pulsatile perfusion might prevent placental vasoconstriction. We report on 4 patients who underwent cardiac surgery during pregnancy with pulsatile perfusion and detailed fetal monitoring.

Clinical summaries

PATIENT 1. A 31-year-old woman at 11 weeks' gestation presented with palpitation. Transthoracic echocardiography showed severe aortic regurgitation and dilated aortic root (6.9 cm). She underwent aortic root replacement at 12 weeks' gestation with a 27-mm porcine valve and a 30-mm Gelseal graft (Vascutek, Renfrenshire, Scotland). CPB was weaned with no support. The patient was extubated 3 hours after the operation and was discharged at 8 days. Histologic examination confirmed cystic medial necrosis.

PATIENT 2. A 26-year-old woman at 19 weeks' gestation presented with acute shortness of breath. She had undergone open aortic valvotomy at age 15 years for congenital aortic stenosis. Transthoracic echocardiography showed a gradient of 120 mm Hg across the valve. She underwent redo aortic valve replacement . . . [Full Text of this Article]

This article has been cited by other articles:

				M. Jahangiri and J. P. van Besouw Pulsatile Perfusion During Pregnancy Ann. Thorac. Surg., January 1, 2012; 93(1): 356 - 356. [Full Text] [PDF]

				A. S. John, K. W. Arendt, M. D. Abel, and H. M. Connolly Reply. Ann. Thorac. Surg., January 1, 2012; 93(1): 356 - 357. [Full Text] [PDF]

				M. Jahangiri and J. Clark Surgery for type A aortic dissection in pregnant patients with Marfan syndrome Eur J Cardiothorac Surg, February 1, 2006; 29(2): 264 - 264. [Full Text] [PDF]

				M. Sakaguchi Reply to Jahangiri and Clark Eur J Cardiothorac Surg, February 1, 2006; 29(2): 264 - 265. [Full Text] [PDF]