Cardiac disease in pregnancy catheterization

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Special Scenarios: I. Pre-existing Cardiac Disease: Congenital Heart Disease Repaired Congenital Heart Disease Pulmonary Hypertension Rheumatic Heart Disease Connective Tissue Disorders II. Valvular Heart Disease: Mitral Stenosis Mitral Regurgitation Aortic Insufficiency Aortic Stenosis Mechanical Prosthetic Valves Tissue Prosthetic Valves III. Cardiomyopathy: Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Peripartum Cardiomyopathy IV. Cardiac diseases that may develop During Pregnancy: Arrhythmias Acute Myocardial Infarction Hypertension
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]

Pulmonary artery Catheterization

Hemodynamic monitoring can be of great help in managing high-risk patients during pregnancy, labor, delivery, and the postpartum period.

The pulmonary artery line should be placed without fluoroscopic guidance. Insertion is recommended throughout labor and delivery for any patient with symptomatic cardiac disease during pregnancy or with the potential for deterioration due to valvular heart disease, myocardial, or ischemic heart disease. Hemodynamic monitoring should be continued for at least several hours after delivery to ensure stability.

Cardiac catheterization

• Catheter ablation is indicated only in rare cases of intractable arrhythmia causing cardiac decompensation. This is because of the high radiation dose involved with catheterization (1.5 mGy).

• To minimize radiation to the pelvic and abdominal areas, the following steps may be considered:

• Radial approach rather than the femoral approach is preferred.
• Shielding the gravid uterus.
• Short fluoroscopic time.

References

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