所属 医学部 医学科（東京女子医科大学病院） 職種 准教授
|発表タイトル||Impact of Pregnancy in Patients with a Systemic Right Ventricle|
|発表者・共同発表者||◎島田衣里子, 篠原徳子, 稲井慶, 朴仁三|
|学会抄録||第81回日本循環器学会学術集会 プログラム集 235|
|概要||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 1 patient 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 2236g (1026g‒ 2984g). Cardiovascular events were observed in 2 patients (33%). No significant echocardiographic changes occurred in systemic RV systolic function parameters (tricuspid annular systolic excursion, the peak systolic colour 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 2 patients, with no recovery 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.