Cirurgia cardíaca com circulação extracorpórea em gestantes. Análise da evolução materno-fetal / Cardiopulmonary Bypass Surgery in Pregnants. Analysis of Maternal and Fetal Outcome

RESUMO

PURPOSE--To analyze maternal and fetal outcome in pregnant undergone to cardiac surgery. METHODS--We studied the evolution of 30 pregnant women submitted to cardiac surgery at the Hospital São Paulo, between Jan/81 and Dec/92 and, further, attended at this Hospital till the parturition. The following variables were analyzed cardiopulmonary bypass, time of the procedure and time of the anoxia, patient temperature, surgical complications, and neonatal, maternal and fetal outcomes. RESULTS--All patients had rheumatic heart disease and, in 17, mitral stenosis was the main anatomic abnormality. Mitral commissurotomy was performed in 24 patients, double comissurotomy (mitral and aortic) in 1 patient and valve replacement was performed in 5. Cardiopulmonary bypass was utilized in all procedure; occurrence of surgical complications (p < 0.001) and the prolonged surgical time (p = 0.009) were related to the fetal mortality. There was 4 (13.3) maternal deaths and 10 (33.3) fetal deaths related to the surgery. CONCLUSION--The indication of cardiac surgery in pregnant women is heart failure, refractory to conventional therapy; cardiopulmonary bypass is associated with high fetal mortality.