Pregnancy outcomes in women with a systemic right ventricle and transposition of the great arteries results from the ESC-EORP Registry of Pregnancy and Cardiac disease (ROPAC).

Tutarel, Oktay; Baris, Lucia; Budts, Werner; Gamal Abd-El Aziz, Mohamad; Liptai, Csilla; Majdalany, David; Jovanova, Silvana; Frogoudaki, Alexandra; Connolly, Heidi M; Johnson, Mark R; Maggioni, Aldo P; Hall, Roger; Roos-Hesselink, Jolien W

doi:10.1136/heartjnl-2020-318685

2022

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Titel:: Pregnancy outcomes in women with a systemic right ventricle and transposition of the great arteries results from the ESC-EORP Registry of Pregnancy and Cardiac disease (ROPAC).
Dokumenttyp:: Journal Article; Research Support, Non-U.S. Gov't
Autor(en):: Tutarel, Oktay; Baris, Lucia; Budts, Werner; Gamal Abd-El Aziz, Mohamad; Liptai, Csilla; Majdalany, David; Jovanova, Silvana; Frogoudaki, Alexandra; Connolly, Heidi M; Johnson, Mark R; Maggioni, Aldo P; Hall, Roger; Roos-Hesselink, Jolien W
Abstract:: OBJECTIVE: Cardiac disease is a major cause of maternal mortality. Data regarding pregnancy outcomes in women with a systemic right ventricle (sRV) are scarce. We studied pregnancy outcomes in women with an sRV after the atrial switch procedure for transposition of the great arteries (TGA) or congenitally corrected TGA (CCTGA). METHODS: The ESC EORP Registry of Pregnancy and Cardiac Disease is an international prospective registry of pregnant women with cardiac disease. Pregnancy outcomes (maternal/fetal) in all women with an sRV are described. The primary end point was a major adverse cardiac event (MACE) defined as maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischaemic coronary event and other thromboembolic events. RESULTS: Altogether, 162 women with an sRV (TGA n=121, CCTGA n=41, mean age 28.8±4.6 years) were included. No maternal mortality occurred. In 26 women, at least one MACE occurred, heart failure in 16 (9.8%), arrhythmias (atrial 5, ventricular 6) in 11 (6.7%) and others in 4 (2.5%). Prepregnancy signs of heart failure as well as an sRV ejection fraction <40% were predictors of MACE. One woman experienced fetal loss, while no neonatal mortality was observed. No significant differences were found between women with CCTGA and TGA. In the subset of women who had an echocardiogram before and after pregnancy, no clear deterioration in sRV was observed. CONCLUSION: The majority of women with an sRV tolerated pregnancy well with a favourable maternal and fetal outcome. Heart failure and arrhythmias were the most common MACE.
Zeitschriftentitel:: Heart
Jahr:: 2022
Band / Volume:: 108
Heft / Issue:: 2
Seitenangaben Beitrag:: 117-123
Volltext / DOI:: doi:10.1136/heartjnl-2020-318685
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/33911009
Print-ISSN:: 1355-6037
TUM Einrichtung:: Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)2022