Bogdan Cherpak
National Amosov Institute of Cardiovascular Surgery NAMS , UkraineTitle: Aorta coarctation management in pregnant
Abstract
Management of coarctation of aorta (CoA) during pregnancy is complicated by heightened procedural risks to the pregnant woman and her fetus. We are reporting about 10-years’ experience of CoA treatment, diagnosed during pregnancy. We had performed percutaneous stents implantations (SI) in 4 women during 15-23 weeks of pregnancy and in 6 women in period 48 hours – 5 years after delivery. CoA was diagnosed by transthoracic echocardiography, the coarctation anatomy was additionally specified with magnetic resonance imaging in 4 pregnant women and computer tomography in 6 patients. All surveyed women had severely arterial hypertension. In all presented cases successful CoA repair was achieved. It was revealed significantly decreasing of peak-to-peak invasive systolic pressure gradient across the CoA (60.0 ± 31.2 and 11.8 ± 7.3 mmHg, p=0.001) and mean noninvasive systolic arterial pressure (163.0 ± 46.2 and 120.5 ± 9.2 mmHg, p=0.01) after SI. All percutaneously treated women during pregnancy (n=4) delivered healthy “full-term” babies. At follow-up (from 2 months to 10 years), all 10 women are alive without significant Doppler gradient across CoA with no signs of aortic aneurysm formation. To our best knowledge we had represented the biggest published cohort of CoA percutaneous treatment during pregnancy. We had categorized our experience in management of aortic coarctation diagnosed during pregnancy in one algorithm. Our experience demonstrates that excellent maternal and neonatal outcome of pregnancy can be obtained in women after CoA percutaneous repair, diagnosed during pregnancy. Aortic stent implantation procedure is effective and safe for both: mother and fetal.
Biography
Bogdan Cherpak completed his Ph.D. at the age of 40 years from the National Amosov Institute of Cardiovascular Surgery NAMS of Ukraine. He is the head of the pediatric cardiology and cardio surgery department at the National Amosov Institute of Cardiovascular Surgery, Ukraine. He is a co-author of 38 scientific publications and constantly participates at congresses and conferences.
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