Percutaneous correction of structural congenital heart diseases during the early puerperium. Experience of a center

Authors

  • Alejandro Narváez Orozco Departamento de Medicina Interna, Universidad de Antioquia, Medellín, Colombia. https://orcid.org/0000-0002-0185-509X
  • Alberto Navarro Navajas Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia, Medellín, Colombia. https://orcid.org/0000-0002-7428-1859
  • Carolina Cardona Buitrago Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia, Medellín, Colombia. https://orcid.org/0000-0002-0820-509X
  • Emilio Herrera Céspedes Servicio de Cardiología, Clínica Medellín, Medellín, Colombia. https://orcid.org/0000-0003-3160-5881
  • Juan Camilo Ortiz Uribe Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia; Grupo para el estudio de las enfermedades cardiovasculares, Universidad de Antioquia, Medellín, Colombia; Servicio Cardiovascular y pulmonar, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0001-9877-0852
  • Juan Andrés Delgado Restrepo Servicio Cardiovascular y pulmonar, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0001-9877-0852
  • Juan Manuel Senior Sánchez Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia; Grupo para el estudio de las enfermedades cardiovasculares, Universidad de Antioquia, Medellín, Colombia; Servicio Cardiovascular y pulmonar, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0001-8312-7194
  • Jairo Alfonso Gándara Ricardo Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia; Grupo para el estudio de las enfermedades cardiovasculares, Universidad de Antioquia, Medellín, Colombia; Servicio Cardiovascular y pulmonar, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0003-0757-0033
  • Edison Muñoz Ortiz Sección de Cardiología, departamento de Medicina Interna, Universidad de Antioquia; Grupo para el estudio de las enfermedades cardiovasculares, Universidad de Antioquia, Medellín, Colombia; Servicio Cardiovascular y pulmonar, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0002-5156-7985

DOI:

https://doi.org/10.47487/apcyccv.v5i3.402

Keywords:

Hearts Defects, Congenital, Pregnancy, Postpartum Period

Abstract

Objetive. Congenital heart diseases (CHD) can be found in pregnant women. Although cardiac interventions in the catheterization laboratory are considered safe and effective, it is preferable to wait 3-6 months after delivery to correct simple, uncomplicated CHD; however, this may result in follow-up losses. The objective is to present our experience in correcting CHD during the early puerperium (EP). Materials and Methods. All cases of pregnant women with CHD, including atrial septal defect (ASD), patent ductus arteriosus (PDA), and aortic coarctation (CoA) between 2017-2023, who underwent percutaneous defect correction during the EP were collected. Results. Fifteen pregnant women were included, diagnosed with ASD (5), PDA (6), and CoA (4). Five patients (33.3%) were classified as WHO risk class IV; the procedure was successful in 80% of the cases, and only 1 patient presented complications. Conclusions. In our experience, the closure of uncomplicated congenital defects during the EP did not present major complications and could be a treatment strategy to prevent follow-up losses after delivery in pregnant women with CHD.

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References

Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. 2018 ESC Guidelines for the

management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165-241. doi: 10.1093/eurheartj/ehy340.

Muñoz-Ortiz E, Gándara-Ricardo JA, Velásquez-Penagos JA, Giraldo-Ardila N, Betancur-Pizarro AM, Arévalo-Guerrero EF, et al. Caracterización de la enfermedad cardiaca en pacientes embarazadas y desenlaces hospitalarios materno-fetales. Rev Colomb Cardiol. 2020;27(5):373-9. doi: 10.1016/j.rccar.2019.12.016.

Park K, Bairey Merz CN, Bello NA, Davis M, Duvernoy C, Elgendy IY, et al. Management of Women With Acquired Cardiovascular Disease From Pre-Conception Through Pregnancy and Postpartum. J Am Coll Cardiol. 2021;77(14):1799-812. doi: 10.1016/j.jacc.2021.01.057.

Park K, Bortnick AE, Lindley KJ, Sintek M, Sethi S, Choi C, et al. Interventional Cardiac Procedures and Pregnancy. Compr Rev. 2022;1(5):100427. doi: 10.1016/j.jscai.2022.100427.

Baumgartner H, De Backer J, Babu-Narayan S V, Budts W, Chessa M, Diller GP, et al. 2020 ESC Guidelines for the management of adult

congenital heart disease. Eur Heart J. 2021;42(6):563-645. doi: 10.1093/eurheartj/ehaa554.

Ramlakhan KP, Johnson MR, Lelonek M, Saad A, Gasimov Z, Sharashkina NV, et al. Congenital heart disease in the ESC EORP Registry of Pregnancy and Cardiac disease (ROPAC). IJC Congenital Heart Disease. 2021 May;3:100107. doi.org/10.1016/j.ijcchd.2021.100107.

Senior JM, Fernández A, Rodriguez A. Seguridad de la corrección percutánea de cardiopatías congénitas en mujeres en sus primeros

días posparto. Acta Med Col. 2014;39(2):159-164. doi.org/10.36104/amc.2014.251.

Drenthen W, Pieper PG, Roos-Hesselink JW, van Lottum WA, Voors AA, Mulder BJM, et al. Outcome of Pregnancy in Women With Congenital Heart Disease. J Am Coll Cardiol. 2007;49(24):2303-11. doi: 10.1016/j.jacc.2007.03.027.

Ouzounian JG, Elkayam U. Physiologic Changes During Normal Pregnancy and Delivery. Cardiol Clin. 2012;30(3):317-29. doi: 10.1016/j.ccl.2012.05.004.

Harris IS. Management of Pregnancy in Patients with Congenital Heart Disease. Prog Cardiovasc Dis. 2011;53(4):305-11. doi: 10.1016/j.pcad.2010.08.001.

Zhang Z, Wengrofsky A, Wolfe DS, Sutton N, Gupta M, Hsu DT, et al. Patent Ductus Arteriosus in Pregnancy: Cardio-Obstetrics Management in a Late Presentation. CASE (Phila). 2021;5(2):119-22. doi: 10.1016/j.case.2020.12.002.

Yap S, Drenthen W, Meijboom F, Moons P, Mulder B, Vliegen H, et al. Comparison of pregnancy outcomes in women with repaired versus unrepaired atrial septal defect. BJOG. 2009;116(12):1593-601. doi: 10.1111/j.1471-0528.2009.02301.x.

Ramlakhan KP, Tobler D, Greutmann M, Schwerzmann M, Baris L, Yetman AT, et al. Pregnancy outcomes in women with aortic coarctation. Heart. 2021;107(4):290-8. doi:10.1136/heartjnl-2020-317513.

Lindley KJ, Bairey Merz CN, Asgar AW, Bello NA, Chandra S, Davis MB, et al. Management of Women With Congenital or Inherited Cardiovascular Disease From Pre-Conception Through Pregnancy and Postpartum. J Am Coll Cardiol. 2021;77(14):1778-98. doi: 10.1016/j.jacc.2021.02.026.

Canobbio MM, Warnes CA, Aboulhosn J, Connolly HM, Khanna A, Koos BJ, et al. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation. 2017;135(8):e50-e87. doi: 10.1161/CIR.0000000000000458.

Krishnamoorthy S, Butt M, Lip GYH. Asymptomatic hypoxia in a young pregnant lady — Unusual presentation of atrial septal defect. Int J Cardiol. 2010;143(2):e34-6. doi: 10.1016/j.ijcard.2008.12.039.

Manivannan S, Dadlani G, Parsons M, Crisan L, Belogolovkin V, Sastry N, et al. Surgical repair of atrial septal defect with severe pulmonary hypertension during pregnancy: a case report with literature review. Cardiol Young. 2012;22(5):493-8. doi: 10.1017/S1047951112000492.

Soydemir DF, Johnston T, Clarke B. Percutaneous closure of an atrial septal defect during pregnancy using an Amplatzer

occlusion device. J Obstet Gynaecol (Lahore). 2005;25(7):715-6. doi: 10.1080/01443610500304307.

Halpern DG, Weinberg CR, Pinnelas R, Mehta-Lee S, Economy KE, Valente AM. Use of Medication for Cardiovascular Disease During Pregnancy. J Am Coll Cardiol. 2019;73(4):457-76. doi: 10.1016/j.jacc.2018.10.075.

Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006. Clopidogrel. [citado el 3 de enero de 2024]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK535609/

Published

2024-09-05

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