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

Abstract

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. 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. 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. Women who have undergone an atrial switch procedure for d-TGA have high rates of pregnancy and cardiac complications and should be counseled accordingly.