Open Heart Surgery During Pregnancy

The incidence of heart disease in pregnancy has been gradually falling during the last three decades. Cardiopathy still remains a prominent cause of maternal and fetal mortality during pregnancy. Although the cardiac disease is well known in most of the patients before pregnancy, the potential risk factors of deteriorating cardiac function may not be emphasized to them. These women when pregnant, may develop heart failure due to increased cardiopulmonary requirements. In them, if medical treatment proves insufficient, the cardiac surgery during pregnancy may be life saving. The pregnant state is not optimal for cardiac surgery, as the principle interest in the mother and the foetus is different. We report two pregnant women who underwent unavoidable heart surgery with cardiopulmonary bypass and review the literature regarding optimal management of open heart operation in pregnancy aiming to decrease feto-maternal mortality. Careful technical precautions and continuous cardiotocography help to minimize fetal complications during the cardiopulmonary bypass.