Pregnancy outcomes and mid-term prognosis in women after arterial switch operation for dextro-transposition of the great arteries – Tertiary hospital experiences and review of literature

• Published in: Journal of cardiology 2019-03, Vol.73 (3), p.247-254
• Main Authors: Horiuchi, Chinami, Kamiya, Chizuko A., Ohuchi, Hideo, Miyoshi, Takekazu, Tsuritani, Mitsuhiro, Iwanaga, Naoko, Neki, Reiko, Niwa, Koichiro, Kurosaki, Kenichi, Ichikawa, Hajime, Ikeda, Tomoaki, Yoshimatsu, Jun
• Format: Article
• Language: English
• Subjects: Adult; Arterial switch operation; Arterial Switch Operation - methods; Arterial Switch Operation - statistics & numerical data; Congenital heart disease; Dextro-transposition of the great arteries; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications, Cardiovascular - surgery; Pregnancy Outcome - epidemiology; Risk Factors; Tertiary Care Centers; Transposition of Great Vessels - surgery; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2018.11.007

•Pregnancies in women with dextro-transposition of the great arteries after arterial switch operation (ASO) were tolerated well.•Adverse maternal events may relate to older age at ASO, elderly pregnancy, higher levels of brain natriuretic peptide.•Midterm prognosis was favorable in ASO group relative to atrial switch group.•Adverse effects of pregnancy may be less in ASO group relative to atrial switch group. Arterial switch operation (ASO) for dextro-transposition of the great arteries (d-TGA) has gradually replaced the atrial switch operation and has become the standard operation. To date, the outcomes of pregnant women with d-TGA after this new operation have not been investigated. In this study, we investigated the impact of ASO on pregnant outcomes and mid-term prognosis in women with d-TGA and compared with the atrial switch operation through the literature review. There were 20 pregnancies in 10 women with d-TGA after ASO and 6 resulted in abortion. Among 14 successful pregnancies in 10 women, 11 pregnancies achieved the term delivery and 3 pregnancies, including 1 twin pregnancy, resulted in preterm labor. Maternal cardiovascular events occurred in 4 (heart failure and arrhythmias in 3 and arrhythmia in 1), and all were controllable with medications. Risk factors for the peripartum cardiac events were older age at ASO and delivery, and higher concentration of brain natriuretic peptide (BNP) at first trimester (p