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
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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. / 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; ROPAC (Registry of Pregnancy and Cardiac Disease) Investigators Group *.
In: J AM HEART ASSOC, Vol. 10, No. 1, 05.01.2021, p. e018176.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - 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
AU - Tutarel, Oktay
AU - Ramlakhan, Karishma P
AU - Baris, Lucia
AU - Subirana, Maria T
AU - Bouchardy, Judith
AU - Nemes, Attila
AU - Vejlstrup, Niels G
AU - Osipova, Olga A
AU - Johnson, Mark R
AU - Hall, Roger
AU - Roos-Hesselink, Jolien W
AU - ROPAC (Registry of Pregnancy and Cardiac Disease) Investigators Group
PY - 2021/1/5
Y1 - 2021/1/5
N2 - 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.
AB - 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.
KW - Adult
KW - Arterial Switch Operation/adverse effects
KW - Europe/epidemiology
KW - Female
KW - Heart Failure/epidemiology
KW - Humans
KW - Infant, Newborn
KW - Male
KW - Pregnancy
KW - Pregnancy Complications, Cardiovascular/diagnosis
KW - Pregnancy Outcome/epidemiology
KW - Registries/statistics & numerical data
KW - Risk Assessment/methods
KW - Tachycardia, Ventricular/epidemiology
KW - Transposition of Great Vessels/epidemiology
U2 - 10.1161/JAHA.120.018176
DO - 10.1161/JAHA.120.018176
M3 - SCORING: Journal article
C2 - 33350866
VL - 10
SP - e018176
JO - J AM HEART ASSOC
JF - J AM HEART ASSOC
SN - 2047-9980
IS - 1
ER -