イナイ ケイ   Inai Kei
  稲井 慶
   所属   医学部 医学科(東京女子医科大学病院)
   職種   准教授
言語種別 日本語
発表タイトル 体心室が右室である心疾患の妊娠
会議名 第54回日本小児循環器学会総会・学術集会
主催者 日本小児循環器学会
学会区分 全国規模の学会
発表形式 ポスター掲示
講演区分 一般
発表者・共同発表者◎島田衣里子, 篠原徳子, 稲井慶, 杉山央
発表年月日 2018/07/05
開催地
(都市, 国名)
横浜市
概要 *ポスターセッション01
周産期・心疾患合併妊婦 1

【 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.