{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:23:55Z","timestamp":1784903035652,"version":"3.55.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Antenatal cardiovascular disease is a major cause of maternal morbidity and mortality. Severe rheumatic mitral stenosis is especially poorly tolerated during pregnancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case Summary<\/jats:title>\n                  <jats:p>We present a young woman with severe pulmonary hypertension secondary to rheumatic mitral stenosis. She presented at 25 weeks 4 days gestation for evaluation of a pregnancy complicated by placenta accreta spectrum disorder. Invasive hemodynamic testing was carried out to delineate her hemodynamics, and a multidisciplinary cardio-obstetrics team collaborated closely with the patient and her partner to create a management plan. Ultimately, the patient was initiated on veno-arterial extracorporeal membrane oxygenation and underwent caesarean section delivery followed by hysterectomy and subsequent valve replacement surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case describes the treatment options considered to balance the risk of decompensation in the setting of severe pulmonary hypertension with hemorrhage associated with placenta accreta spectrum disorder. It highlights the importance of a multidisciplinary, team-based approach to the management of high-risk cardiac conditions throughout pregnancy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae055","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T09:23:05Z","timestamp":1706520185000},"source":"Crossref","is-referenced-by-count":5,"title":["Case report of pregnancy complicated by severe pulmonary hypertension from mitral stenosis and placenta accreta spectrum disorder: management of two life-threatening conditions"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-0163","authenticated-orcid":false,"given":"Jaya","family":"Batra","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St, PH 12 STEM , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirella","family":"Mourad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fady Khoury","family":"Collado","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takeda","sequence":"additional","affiliation":[{"name":"Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Greenwald","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Ring","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuxin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons , 630 W 168th St , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3506-5157","authenticated-orcid":false,"given":"Jennifer","family":"Haythe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons 1 , 630 W 168th St, PH 12 STEM , New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"2024021514540862000_ytae055-B1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/eurheartj\/ehs270","article-title":"Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European society of cardiology","volume":"34","author":"Roos-Hesselink","year":"2013","journal-title":"Eur Heart 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