European Heart Journal Advance Access originally published online on January 28, 2005
European Heart Journal 2005 26(9):914-920; doi:10.1093/eurheartj/ehi103
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pregnancy and aortic root growth in the Marfan syndrome: a prospective study
1Department of Cardiology, Rm B2-240, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
2Department of Cardiology, University Hospital Nijmegen, Nijmegen, The Netherlands
3Department of Internal Medicine, University Hospital Nijmegen, Nijmegen, The Netherlands
4Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
Received 5 August 2004; revised 2 November 2004; accepted 25 November 2004; online publish-ahead-of-print 28 January 2005.
* Corresponding author. Tel: +31 20 5662193; fax: +31 20 5666809. E-mail address: b.j.mulder{at}amc.uva.nl
Aims In women with Marfan syndrome pregnancy presents an increased risk of dilatation, dissection, and rupture of the aorta. The aim of this study was to investigate the influence of pregnancy on growth of the aortic root.
Methods and results Between 1993 and 2004 127 women with Marfan syndrome were prospectively followed; 61 women had one or more children; in 23 women, 33 pregnancies could be followed prospectively for aortic dimensions. Only one woman had suffered an aortic complication, a type A dissection (limited to the ascending aorta), before pregnancy. Out of 66 childless women a comparison group of 22 women was selected and individually matched. Mean initial aortic root diameter just before pregnancy was 37±5 mm (range 25–45). Before, during, and after pregnancy the overall individual aortic root diameter change (in 31 pregnancies) was not significant (P=0.77). Only the woman with a previous type A dissection developed an aortic complication (type B dissection) during her second pregnancy. No cardiac complications occurred in the other 22 women during their pregnancies. During a median follow-up of 6.4 years, no significant difference in growth of the aortic root was observed between the pregnancy group and the matched childless group (0.28 vs. 0.19 mm/year, P=0.08, respectively).
Conclusion Pregnancy in women with Marfan syndrome seems to be relatively safe up to an aortic root diameter of 45 mm, at least as far as our observed diameter range of 25–45 mm is concerned.
Key Words: Marfan syndrome • Pregnancy • Aortic root diameter • Aortic root growth • Guidelines • Aortic complication
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. I. Singh, C. Brooks, and W. Dobkowski General anesthesia using remifentanil for Cesarean delivery in a parturient with Marfan's syndrome: [Anesthesie generale avec du remifentanil pour un accouchement par cesarienne chez une parturiente souffrant du syndrome de Marfan] Can J Anesth, August 1, 2008; 55(8): 526 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. G. Keane and R. E. Pyeritz Medical Management of Marfan Syndrome Circulation, May 27, 2008; 117(21): 2802 - 2813. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Wakiyama, M. Nasu, H. Fujiwara, A. Kitamura, and Y. Okada Two Surgical Cases of Acute Aortic Dissection in Pregnancy with Marfan Syndrome Asian Cardiovasc Thorac Ann, October 1, 2007; 15(5): e63 - e65. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Singh and C. Brooks 44619 - ANESTHETIC MANAGEMENT OF A PARTURIENT WITH MARFAN SYNDROME: CASE REPORT or SERIES Can J Anesth, August 1, 2007; 54(suppl_1): 44619 - 44619. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Hayashi, A. D. Cochrane, S. Menahem, and J. A. Smith Neoaortic root dilatation with saccular aneurysm formation after the arterial switch operation for Taussig-Bing anomaly J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 569 - 572. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hager, H. Kaemmerer, and J. Hess Comment on pregnancy and aortic root growth in the Marfan syndrome Eur. Heart J., November 1, 2005; 26(21): 2346 - 2346. [Full Text] [PDF]
|
|
|
|
|
|
B. J.M. Mulder and L. J. Meijboom Comment on pregnancy and aortic root growth in the Marfan syndrome: reply Eur. Heart J., November 1, 2005; 26(21): 2346 - 2347. [Full Text] [PDF]
|
|