Resumo

SALAZAR, Eduardo et al. Heart surgery with cardiopulmonary bypass in pregnant women. Arch. Cardiol. Méx. [online]. 2001, vol.71, n.1, pp.20-27. ISSN 1665-1731.

Abstract Objective: Definite data in heart surgery with extracorporeal circulation during pregnancy is limited. This report analyzes our experience in this area. Methods: Fifteen women underwent open heart surgery under cardiopulmonary bypass during pregnancy at our institution between 1972 and 1998. Surgical procedures included valve replacement in 13 patients (12 mitral, 1 aortic), declotting of a tilting disk mitral prosthesis in one and closure, of an atrial septal defect in the remaining patient. Results: Thirteen patients were in New York Heart Association functional class III to IV and were operated on urgently. Eight of these women had severe acute dysfunction of either a mechanical or a biological mitral prosthesis. There were 2 maternal operative deaths for a rate of 13.3%. Fetal losses resulted at the time of these maternal deaths. Fetal deaths occurred in 5 of the 13 pregnancies (38.5%) in women who survived the surgical procedure. Conclusions: Because of the fetal risks, open heart surgery during pregnancy should be advised only in extreme emergencies. Although pregnancy per se does not increase the maternal risk, a high maternal mortality results from the emergency nature of the surgical intervention. Fetal mortality remains high.

Palavras-chave : Heart surgery; Cardiopulmonary bypass; Pregnancy; Cirugía de corazón; Circulación extracorpórea; Embarazo.

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