[P01-03] 体心室が右室である心疾患の妊娠
Keywords:成人先天性心疾患, 妊娠, 大血管転位
【Background】Pregnancy is increasing common in women with congenital heart disease, but little is known about the effect of pregnancy on a systemic right ventricle (RV). This study aimed to assess the clinical status and the changes in cardiac function during pregnancy in patients with a systemic RV.
【Methods】Five patients after atrial switch operation (including 1 patient after tricuspid valve replacement) of complete transposition of the great arteries, and 2 patients with congenital corrected transposition of the great arteries were enrolled. Serial echocardiographic examinations were performed at the second and the third trimester gestation and postpartum.
【Results】All women were in New York Heart Association functional class I before pregnancy and remained unchanged after delivery. Median gestational age was 35 (28 - 37) weeks, and median birthweight was 2297g (1026g- 2984g). Cardiovascular events were observed in 2 patients (29%). No significant echocardiographic changes occurred in systemic RV systolic function parameters (tricuspid annular systolic excursion, the peak systolic color tissue velosity Doppler of the RV lateral wall assessed at the tricuspid annulus, RV fractional area change, and isovolumic myocardial acceleration) during and after pregnancy. Worsening tricuspid regurgitation was observed in 3 patients, with symptoms of heart failure after delivery in one patient.
【Conclusions】Pregnancy can be achieved in patients with systemic RV, although maternal cardiovascular complications and worsening tricuspid regurgitation sometimes occurs in pregnancy.
【Methods】Five patients after atrial switch operation (including 1 patient after tricuspid valve replacement) of complete transposition of the great arteries, and 2 patients with congenital corrected transposition of the great arteries were enrolled. Serial echocardiographic examinations were performed at the second and the third trimester gestation and postpartum.
【Results】All women were in New York Heart Association functional class I before pregnancy and remained unchanged after delivery. Median gestational age was 35 (28 - 37) weeks, and median birthweight was 2297g (1026g- 2984g). Cardiovascular events were observed in 2 patients (29%). No significant echocardiographic changes occurred in systemic RV systolic function parameters (tricuspid annular systolic excursion, the peak systolic color tissue velosity Doppler of the RV lateral wall assessed at the tricuspid annulus, RV fractional area change, and isovolumic myocardial acceleration) during and after pregnancy. Worsening tricuspid regurgitation was observed in 3 patients, with symptoms of heart failure after delivery in one patient.
【Conclusions】Pregnancy can be achieved in patients with systemic RV, although maternal cardiovascular complications and worsening tricuspid regurgitation sometimes occurs in pregnancy.