Heart and vessels
-
Multicenter Study
Clinical features and peripartum outcomes in pregnant women with cardiac disease: a nationwide retrospective cohort study in Japan.
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes. ⋯ Multivariable logistic regression analysis showed a significant positive association between pre-existing cardiac disease and risk of heart failure (adjusted odds ratio, 24.7; 95% confidence interval, 17.6-34.6; p < 0.001). No woman in the cardiac disease group died, whereas 18 women (0.02%) in the non-cardiac disease group did (p = 1.000). These findings suggest that pregnant women with pre-existing cardiac disease are at a higher risk of heart failure during the peripartum period than those with non-cardiac comorbidities.
-
Cox-maze IV ablation by bipolar radiofrequency clamp was considered to be only performed through median sternotomy (MS), but impossible through right minithoracotomy (RM). Now, we developed a novel technique of performing Cox-maze IV ablation entirely by bipolar clamp through RM. To compare the outcomes of RM or MS for patients undergoing mitral valve surgery and concomitant Cox-maze IV ablation with entirely bipolar clamp. ⋯ Cumulative maintenance of NSR at 2 years postoperatively was 85.1 ± 5.8% in RM group and 88.6 ± 3.6% in MS group (P = 0.767). RM can achieve similar therapeutic effect to MS for patients undergoing mitral valve surgery and concomitant Cox-maze IV ablation with entirely bipolar clamp. In addition, patients through RM had faster recovery.