Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Pregnancy in patients with pulmonary autograft valve replacement
The Grown-Up Congenital Heart (GUCH) Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, U.K.
Received 24 March 1997; accepted 26 March 1997.
Correspondence: Jane Somerville MD, GUCH Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP
Abstract
AIMS: The purpose of this study is to determine the outcome and complications of pregnancy in women with pulmonary autograft valve replacement for aortic valve disease.
METHODS AND RESULTS: The records of all women who had undergone pulmonary autograft valve replacement at the National Heart Hospital (now Royal Brompton Hospital) since 1968 were reviewed. From 1968 to 1993, 27 hospital survivors were female and among eight of them there were 14 pregnancies. All women were in Ability Index 1 at time of pregnancy with normal ventricular function, mild aortic regurgitation (six), mild pulmonary regurgitation (three) and mild pulmonary stenosis (two). None took anticoagulants. There was no maternal death, thromboembolic or haemorrhagic event or evidence of deterioration in valve function during pregnancy. Except for one woman (Ability Index 3) who developed dilated cardiomyopathy without aortic or pulmonary valve disease 6 months after delivery, the women remained in Ability Index 1 after pregnancy. There was no significant progression of aortic regurgitation (mild after seven pregnancies), pulmonary regurgitation (mild after six) or right-sided obstruction (mild after four). Reoperation for right-sided obstruction was carried out in two patients 4 and 7 years after a second pregnancy (9 and 15 years after the pulmonary autograft).
CONCLUSIONS: No valve-related complications occurred during pregnancy and pregnancy appeared to have no effect on the function of the pulmonary valve autograft or the right-sided homograft. The pulmonary autograft is thus an ideal procedure for a young female needing aortic valve replacement.
Key Words: Aortic valve • pregnancy • pulmonary autograft
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