title: Pregnancy-Related Cardiovascular Complications: Case Presentation and Review of Literature.
abstract: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications.
  
  
  
  A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period. We used levosimendan as a potent inodilator in all patients to increase feto-placental blood flow and fetal heart rhythm.
  
  
  
  Median time to diagnosis was 23.8 h (range 11.7-120 h) and median time from diagnosis to arrival in the operating theater was 9.8 h (range 7.4-19.8 h). One patient with prosthetic heart valve thrombosis underwent concomitant cesarean section prior to cardiac surgery. In a young pregnant woman who had spontaneous dissection of the left anterior descending artery, on-pump beating heart coronary artery bypass grafting was performed without cross clamping. Two and three months after surgery, cesarean sections were performed without any complication in two pregnant women.
  
  
  
  Because unusual cardiovascular complications are the main cause of maternal and/or fetus death during pregnancy, prompt and exact diagnosis is very important. Life-saving surgical strategy with the help of appropriate teams are necessary to optimize outcome for both mother and baby.
authors: Department of Radiology, The Health and Sciences University, Tunceli Government Hospital, Tunceli, Turkey.
authors: Hasan Baki
authors: HB
authors: Altinsoy
authors: Department of Radiology, The Health and Sciences University, Tunceli Government Hospital, Tunceli, Turkey.
authors: Ozkan
authors: O
authors: Alatas
authors: Department of Cardiology, The Health and Sciences University, Adana Numune Education and Research Hospital, Adana, Turkey.
authors: Salih
authors: S
authors: Colak
authors: Department Cardiovascular Surgery, The Health and Sciences University, Adana Numune Education and Research Hospital, Adana, Turkey.
authors: Hakan
authors: H
authors: Atalay
authors: Department Cardiovascular Surgery, The Health and Sciences University, Adana Numune Education and Research Hospital, Adana, Turkey.
authors: Omer Faruk
authors: OF
authors: Dogan
mesh_terms: D000328:Adult; D001019:Aortic Rupture / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D003330:Coronary Vessel Anomalies / Q000601:surgery*; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D013927:Thrombosis / Q000601:surgery*; D014652:Vascular Diseases / Q000151:congenital* / Q000601:surgery