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

Am J Obstet Gynecol. 2011 Sep;205(3):273.e1-5. doi: 10.1016/j.ajog.2011.06.042. Epub 2011 Jun 17.

Abstract

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.

MeSH terms

  • Adult
  • Cardiac Surgical Procedures / methods
  • Female
  • Heart Atria / physiopathology
  • Heart Atria / surgery*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / physiopathology*
  • Pregnancy Outcome*
  • Premature Birth
  • Retrospective Studies
  • Transposition of Great Vessels / physiopathology
  • Transposition of Great Vessels / surgery*
  • Ventricular Dysfunction, Right / physiopathology*