Invasive tests in pregnancy.

2014·0.12 MB·English

by  Roscani, Meliza Goi

READERS OPINION
Invasive tests in pregnancy
MelizaGoiRoscani,ISilmeiaG.Zanati,IIPericlesS.Salmazo,II,IIIFabio C.Carvalho,IIClaudiaG.Magalha˜es,IV
Vera Therezinha M. Borges,IV Beatriz B. Matsubara,II Joa˜o C. HuebII
ISa˜o Carlos Federal University (UFSCar) Department of Medicine, Internal Medicine, Sa˜o Carlos/SP, Brazil. IIUniversidade Estadual Paulista Julio de
MesquitaFilho(UNESP),FaculdadedeMedicinadeBotucatu,InternalMedicine,Botucatu/SP,Brazil.IIIUniversidadeEstadualPaulistaJuliodeMesquita
Filho(UNESP),FaculdadedeMedicinadeBotucatu,Cardiology,Botucatu/SP,Brazil.IVUniversidadeEstadualPaulistaJuliodeMesquitaFilho(UNESP),
FaculdadedeMedicinadeBotucatu,GynecologyandObstetrics,Botucatu/SP,Brazil.
Email:[email protected]
Tel.:[phone]
The letter to the editor ‘‘Safety concerns in pregnancy’’, gold standard method to investigate coronary fistulas and
written by Yalcinkaya et al. (1), was very interesting, anomalousoriginofacoronaryarteryandcanbeperformed
questioning the real benefits of performing invasive tests withaverylowrisktoeitherthemotherorfetuswhenthe
during pregnancy. In particular, regarding the case report recommended precautions are observed, including appro-
entitled‘‘Congenitalaneurysmalcircumflexcoronaryartery priate abdominal lead coverage for the mother and
fistulainapregnantwoman’’(2),writtenbyourgroup,the minimized fluoroscopy time (5). Fortunately, in the case
authorsconsiderednobenefitandsuggestedtheremayeven that we presented, cardiac catheterization confirmed the
beapotentiallyharmfuleffectassociatedwithperforminga diagnosis of a coronary fistula, enabling clinical manage-
hemodynamicstudyduringpregnancyfortheevaluationof ment throughout thetime remaining until the delivery.
anasymptomaticcoronaryfistula.
From our point of view, in this specific case, it was
& REFERENCES
important to perform a hemodynamic study because the
echocardiogram was not completely conclusive for the 1. Yalcinkaya E, Celik M, Bugan B, Yuksel UC. Safety concerns in
diagnosis of a coronary fistula and because there was a pregnancy.Clinics.2013;68(4):4.
substantial risk of a differential diagnosis of anomalous 2. Roscani MG, Zanati SG, Salmazo PS, Carvalho FC, Magalhaes CG,
BorgesVT,etal.Congenitalaneurysmalcircumflexcoronaryarteryfis-
originofthecoronaryarteries(3).Inthepresentedcase,the
tula in a pregnant woman. Clinics. 2012;67(12):1523-5, http://dx.doi.
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Circulation.2007;115(10):1296-305.
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4. ZavalloniD,BelliG,CarattiA,PresbiteroP.Anomalousoriginoftheleft
coronaryarterycaninduceischemiceventsinbothamother coronaryarteryfromthepulmonaryarteryinanadultpregnantpatient:
and her fetus at the end of pregnancy and during the surgical and percutaneous myocardial revascularization. Ital Heart J.
delivery period (4). Therefore, it was imperative to 2005;6(4):348-52.
5. Sharma UM, Aslam AF, Tak T. Diagnosis of coronary artery fistulas:
definitivelydiscardthepossibilityofthatharmfulcondition.
clinical aspects and brief review of the literature. Int J Angiol.
An invasive hemodynamic exam is still considered as the 2013;22(3):189-92.
Copyright (cid:2) 2014CLINICS–ThisisanOpenAccessarticledistributedunder
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originalworkisproperlycited.
Nopotentialconflictofinterestwasreported.
DOI:10.6061/clinics/2014(07)12
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