Abstract

Rheumatic mitral stenosis is the most common cardiac disease complicating pregnancy in India constituting almost 88% of the cardiac diseases in pregnancy. Surgical valve replacement during pregnancy is reserved for those patients in whom percutaneous techniques are not feasible or in whom medical management has failed. Although cardiac surgery during pregnancy is associated with significant maternal and fetal risks, it can be carried out safely by a meticulous plan of anesthesia and making modifications in the initiation and maintenance if cardiopulmonary bypass. In this report, we present the successful perioperative management of a patient posted for mitral valve replacement at 17 weeks of gestation with a huge left atrial clot and a live fetus.

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