Case report
Homograft aortic root replacement during pregnancy

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Abstract

Operative cardiac interventions have been performed on pregnant women with varying degrees of success since the late 1950s. Currently, reported maternal mortality for cardiac operations is similar to the mortality rate for nonpregnant female patients. However, fetal mortality remains high, at approximately 20%. Aortic root replacement with an aortic homograft in a 34-year-old pregnant woman with bacterial endocarditis at 18 weeks gestation is presented. Fetal echocardiography during and after bypass was employed.

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Comment

We have not seen any other cases reported of homograft aortic root replacement during pregnancy or of the use of fetal echocardiography during CPB. In a recent review of 69 cases of CPB during pregnancy, maternal and fetal mortality were 2.9% and 20.2%, respectively. The last 40 of these 69 cases had a reported maternal mortality of 0% and a fetal mortality of 12.5% [1]. Thus, the overall risk of CPB has recently shifted mostly to the fetus. Despite the limited experimental data regarding the

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Copyright © 2002 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.