(276) Pregnancy outcomes in women with transposition of the great arteries: single-center cohort of 13 patients

We identified 19 pregnancies in 13 patients with a maternal history of transposition of the great arteries. Thirteen pregnancies occurred in 8 patients (62%) with an atrial switch procedure, and 6 pregnancies in 5 patients with an arterial switch procedure (38%). All patients were seen in our Cardio-Obstetrics Clinic and evaluated with serial echocardiography throughout their pregnancies.

 
Obstetrical and neonatal outcomes are demonstrated in Table 1. NYHA class I and II were in 16 (84%) and 3 (16%) patients respectively. One pregnancy was complicated by sustained supraventricular tachycardia (5%). One pregnancy (5%) was complicated by pulmonary edema postpartum. Table 2 summarizes baseline and postpartum echocardiogram results. One atrial switch patient had progression from moderate to severe AV regurgitation. One atrial switch pregnancy (5%) was complicated by heart failure postpartum with severely depressed ventricular function. At baseline, all arterial switch patients had trivial to mild aortic valve regurgitation and pulmonary regurgitation, and three arterial switch patients had increased aortic root dilation (75%).

Conclusion: Our findings reinforce previous reports that pregnancy is overall well tolerated in patients with transposition of the great arteries. These results provide reassurance for women with transposition of the great arteries, either following atrial or arterial switch, who are planning for pregnancy.