Cardiopulmonary bypass in pregnancy: possible new role for the intra-aortic balloon pump.
Cardiopulmonary bypass (CPB) during pregnancy is associated with a maternal mortality similar to the nonpregnant population; however, fetal morbidity and mortality are high. Various strategies to improve fetal survival have been advocated. Alteration in uterine artery flow velocity has been reported during nonpulsatile CPB; however, roller pump-generated pulsatile flow for CPB remains controversial. We report use of the intra-aortic balloon pump (IABP) in two cases of pregnancy. In the first, the IABP was inserted after termination of a long bypass, specifically in an attempt to improve uterine perfusion and thereby relieve a profound fetal bradycardia. In the second, the IABP was used electively to provide pulsatile flow during the bypass period primarily to benefit fetal hemodynamics.
Willcox
Timothy W
TW
Cardiothoracic Surgical Unit, Green Lane Hospital, Green Lane West, Auckland, New Zealand. timw@adhb.govt.nz
Stone
Peter
P
Milsom
F Paget
FP
Connell
Henry
H
D000328:Adult; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D009520:New Zealand; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011256:Pregnancy Outcome; D012039:Regional Blood Flow; D013222:State Medicine