Acute mitral valve endocarditis at the 24th gestational week
Tóm tắt
Infective endocarditis during pregnancy and subsequent cardiac surgery are rare and carry a high mortality risk for both the mother and fetus. We report our experience with a previously healthy, 22-year-old woman affected by acute active mitral endocarditis due to Streptococcus gordonii at the 24th gestational week, who wished to continue with the pregnancy. Due to cardiogenic shock, an intra-aortic balloon pump was inserted. Our patient successfully underwent mitral valve replacement with normothermic high-flow cardiopulmonary bypass and continuous intraoperative fetus monitoring. She delivered a 2524-g baby vaginally at the 38th gestational week. Both the mother and child were confirmed to be doing well at the 1-year follow-up. Although this was the first case, urgent cardiac surgery and a subsequent childbirth went well by prompt decision of each department.
Tài liệu tham khảo
Kebed KY, Bishu K, Al Adham RI, Baddour LM, Connolly HM, Sohail MR, et al. Pregnancy and postpartum infective endocarditis: a systematic review. Mayo Clin Proc. 2014;89:1143–52.
Arnoni RT, Arnoni AS, Bonini RCA, de Almeida AFS, Neto CA, Dinkhuysen JJ, et al. Risk factors associated with cardiac surgery during pregnancy. Ann Thorac Surg. 2003;76:1605–8.
Mahli A, Izdes S, Coskun D. Cardiac operations during pregnancy: review of factors influencing fetal outcome. Ann Thorac Surg. 2000;69:1622–6.
Younge N, Goldstein RF, Bann CM, Hintz SR, Patel RM, Smith B, et al. Survival and neurodevelopmental outcomes among periviable infants. N Engl J Med. 2017;376:617–28.
Ishii N, Kono Y, Yonemoto N, Kusuda S, Fujimura M. Outcomes of infants born at 22 and 23 weeks’ gestation. Pediatrics. 2013;132:62–71.
Leyse R, Ofstun M, Dillard DH, Merendino KA. Congenital aortic stenosis in pregnancy, corrected by extracorporeal circulation, offering a viable male infant at term but with anomalies eventuating in his death at four months of age–report of a case. JAMA. 1961;176:1009–122.
Kapoor MC. Cardiopulmonary bypass in pregnancy. Ann Card Anaesth. 2014;17:33–9.
Sakaguchi M, Kitahara H, Seto T, Furusawa T, Fukui D, Yanagiya N, et al. Surgery for acute type A aortic dissection in pregnant patients with Marfan syndrome. Eur J Cardiothorac Surg. 2005;28:280–3.