Cardiac surgery during pregnancy

Cardiac surgery in pregnant women is generally avoided due to risks to both mother and fetus. In rare circumstances where hemodynamics are compromised, cardiac intervention in a pregnant woman cannot be avoided. In these situations, special care in anesthetic management, conduct of cardiopulmonary bypass, and intraoperative monitoring of the fetus may decrease risks of fetal loss, however, fetal complications remain common in this setting. Valvular heart disease is the most common indication for heart surgery in pregnant patients, and the most prevalent pathologies affect the left side of the heart. Pregnancy itself appears to be a risk factor for aortic disease, and in women <40 years old, almost 50% of all aortic aneurysm ruptures and dissections occur in those who are pregnant. Coronary artery dissection is the most common cause of pregnancy-associated myocardial infarction and atherosclerosis occurs less frequently.