Cardiopulmonary Bypass in Pregnancy. A Single-Center Experience

The aim: Presentation of a single-center experience of cardiac surgery with cardiopulmonary bypass (CPB) in pregnant women with critical cardiac pathology. The possibility of minimally invasive technique in this group of patients were presented. Materials and methods: The present study included 19 cases of multidisciplinary care with CPB surgery in pregnant women in single center from December 2013 to December 2020. 8 patients underwent J-form median mini-sternotomy. Maternal and neonatal outcomes depending on the type of surgery (urgent or elective) were reviewed. Results: There were no negative maternal consequences; there were 4 perinatal losses (21%): three after urgent and one after elective interventions. All other pregnancies (n=15) finished successfully with the birth of healthy newborns. We compared some values in two groups (urgent and elective) of patients who underwent CPB surgery during pregnancy. Despite the variability in some parameters the difference between the groups was not significant. Follow-up was from 5 to 72 months (39.7±16.9) without negative consequences. Conclusions: Multidisciplinary team management is an effective strategy for pregnant women with cardiac pathology. Elective cardiac surgery in expert centers during pregnancy is a safe and effective option. Urgent CPB cardiac surgery during pregnancy increases the risk for the fetus. J-form median mini-sternotomy is a good option during pregnancy in high-experienced centers.