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Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme
BACKGROUND: In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955508/ https://www.ncbi.nlm.nih.gov/pubmed/33350866 http://dx.doi.org/10.1161/JAHA.120.018176 |
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author | Tutarel, Oktay Ramlakhan, Karishma P. Baris, Lucia Subirana, Maria T. Bouchardy, Judith Nemes, Attila Vejlstrup, Niels G. Osipova, Olga A. Johnson, Mark R. Hall, Roger Roos‐Hesselink, Jolien W. |
author_facet | Tutarel, Oktay Ramlakhan, Karishma P. Baris, Lucia Subirana, Maria T. Bouchardy, Judith Nemes, Attila Vejlstrup, Niels G. Osipova, Olga A. Johnson, Mark R. Hall, Roger Roos‐Hesselink, Jolien W. |
author_sort | Tutarel, Oktay |
collection | PubMed |
description | BACKGROUND: In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the great arteries after arterial switch is not yet included in the modified World Health Organization classification of maternal cardiovascular risk. METHODS AND RESULTS: The ROPAC (Registry of Pregnancy and Cardiac disease) is an international prospective registry of pregnant women with cardiac disease, part of the European Society of Cardiology EURObservational Research Programme. Pregnancy outcomes in all women after an arterial switch procedure for transposition of the great arteries are described. The primary end point was a major adverse cardiovascular event, defined as combined end point of maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischemic coronary events, and thromboembolic events. Altogether, 41 pregnant women (mean age, 26.7±3.9 years) were included, and there was no maternal mortality. A major adverse cardiovascular event occurred in 2 women (4.9%): heart failure in one (2.4%) and ventricular tachycardia in another (2.4%). One woman experienced fetal loss, whereas no neonatal mortality was observed. CONCLUSIONS: Women after an arterial switch procedure for transposition of the great arteries tolerate pregnancy well, with a favorable maternal and fetal outcome. During counseling, most women should be reassured that the risk of pregnancy is low. Classification as modified World Health Organization risk class II seems appropriate. |
format | Online Article Text |
id | pubmed-7955508 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79555082021-03-17 Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme Tutarel, Oktay Ramlakhan, Karishma P. Baris, Lucia Subirana, Maria T. Bouchardy, Judith Nemes, Attila Vejlstrup, Niels G. Osipova, Olga A. Johnson, Mark R. Hall, Roger Roos‐Hesselink, Jolien W. J Am Heart Assoc Original Research BACKGROUND: In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the great arteries after arterial switch is not yet included in the modified World Health Organization classification of maternal cardiovascular risk. METHODS AND RESULTS: The ROPAC (Registry of Pregnancy and Cardiac disease) is an international prospective registry of pregnant women with cardiac disease, part of the European Society of Cardiology EURObservational Research Programme. Pregnancy outcomes in all women after an arterial switch procedure for transposition of the great arteries are described. The primary end point was a major adverse cardiovascular event, defined as combined end point of maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischemic coronary events, and thromboembolic events. Altogether, 41 pregnant women (mean age, 26.7±3.9 years) were included, and there was no maternal mortality. A major adverse cardiovascular event occurred in 2 women (4.9%): heart failure in one (2.4%) and ventricular tachycardia in another (2.4%). One woman experienced fetal loss, whereas no neonatal mortality was observed. CONCLUSIONS: Women after an arterial switch procedure for transposition of the great arteries tolerate pregnancy well, with a favorable maternal and fetal outcome. During counseling, most women should be reassured that the risk of pregnancy is low. Classification as modified World Health Organization risk class II seems appropriate. John Wiley and Sons Inc. 2020-12-22 /pmc/articles/PMC7955508/ /pubmed/33350866 http://dx.doi.org/10.1161/JAHA.120.018176 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Tutarel, Oktay Ramlakhan, Karishma P. Baris, Lucia Subirana, Maria T. Bouchardy, Judith Nemes, Attila Vejlstrup, Niels G. Osipova, Olga A. Johnson, Mark R. Hall, Roger Roos‐Hesselink, Jolien W. Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme |
title | Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme |
title_full | Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme |
title_fullStr | Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme |
title_full_unstemmed | Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme |
title_short | Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme |
title_sort | pregnancy outcomes in women after arterial switch operation for transposition of the great arteries: results from ropac (registry of pregnancy and cardiac disease) of the european society of cardiology eurobservational research programme |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955508/ https://www.ncbi.nlm.nih.gov/pubmed/33350866 http://dx.doi.org/10.1161/JAHA.120.018176 |
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