Pregnancy outcomes in women who have undergone an atrial switch repair for congenital d-transposition of the great arteries

Objective Women who underwent an atrial switch procedure (Senning or Mustard) for repair of d-transposition of the great arteries (d-TGA) are now of reproductive age. We sought to assess their ability for a successful pregnancy. Study Design Clinical data were reviewed for all women of reproductive...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2011-09, Vol.205 (3), p.273.e1-273.e5
Main Authors: Metz, Torri D., MD, Jackson, G. Marc, MD, Yetman, Anji T., MD
Format: Article
Language:English
Subjects:
Adult
atrial switch
Biological and medical sciences
Cardiac Surgical Procedures - methods
Cardiology. Vascular system
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
d-transposition of the great arteries
Female
Gynecology. Andrology. Obstetrics
Heart
Heart Atria - physiopathology
Heart Atria - surgery
Humans
Infant, Newborn
Infant, Premature
Medical sciences
Mustard procedure
Obstetrics and Gynecology
Pregnancy
Pregnancy Complications, Cardiovascular - physiopathology
Pregnancy Outcome
Premature Birth
Retrospective Studies
Senning procedure
Transposition of Great Vessels - physiopathology
Transposition of Great Vessels - surgery
Ventricular Dysfunction, Right - physiopathology
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Summary:Objective Women who underwent an atrial switch procedure (Senning or Mustard) for repair of d-transposition of the great arteries (d-TGA) are now of reproductive age. We sought to assess their ability for a successful pregnancy. Study Design Clinical data were reviewed for all women of reproductive age who carried a diagnosis of d-TGA and atrial switch procedure who were observed at 2 tertiary care centers over 10 years. Results Among 25 women who were identified, there were 21 pregnancies that resulted in 14 live births. The preterm birth rate was 50%. Pregnancy complications occurred in 5 women. There were no deaths. Serial echocardiographic data demonstrated a fall in right ventricular function during pregnancy, with some improvement postpartum. Intracardiac baffle obstruction that required postpartum stenting occurred in 36% of the completed pregnancies. Conclusion Women who have undergone an atrial switch procedure for d-TGA have high rates of pregnancy and cardiac complications and should be counseled accordingly.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2011.06.042