scholarly journals Solely MRI-Guided Cardiac Catheterization for Assessment of Pulmonary Hypertension in a Pregnant Lady with Undiagnosed Congenital Heart Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Aphrodite Tzifa ◽  
Ioannis Polymerou ◽  
Dimitra Loggitsi
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Mortality Rate ◽  
Adverse Effects ◽  
Risk Stratification ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
Mri Guided

Pregnancy in women with complex congenital heart disease (CHD) can be poorly tolerated. Amongst pregnant women with CHD and pulmonary hypertension (PH), the mortality rate can be as high as 30%. Cardiac catheterization procedures for assessment of haemodynamics and pulmonary vascular resistance (PVR) are often required in this patient population for risk stratification. However, during the first few weeks of pregnancy, this should better be avoided due to the known adverse effects of the ionizing radiation to the immature fetus. In this setting, a solely MRI-guided catheterization may present as a better alternative.

scholarly journals Long-term effect of bosentan in pulmonary hypertension associated with complex congenital heart disease

2013 ◽  
Vol 32 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Rui Baptista ◽  
Graça Castro ◽  
António Marinho da Silva ◽  
Pedro Monteiro ◽  
Luís Augusto Providência
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Congenital Heart ◽  
Term Effect ◽  
Complex Congenital Heart Disease ◽  
Long Term Effect

scholarly journals Severe pulmonary hypertension and reduced right ventricle systolic function associated with maternal mortality in pregnant uncorrected congenital heart diseases

2019 ◽  
Vol 9 (4) ◽  
pp. 204589401988451 ◽  
Author(s):  
Anggoro B. Hartopo ◽  
Dyah W. Anggrahini ◽  
Detty S. Nurdiati ◽  
Noriaki Emoto ◽  
Lucia K. Dinarti
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Mortality Rate ◽  
Right Ventricle ◽  
Maternal Mortality ◽  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Systolic Function

Background Pregnant uncorrected congenital heart disease patients, especially those who already developed pulmonary hypertension, have increased risk for maternal mortality. The pulmonary hypertension severity and right ventricle function may be associated with higher maternal mortality. The study aimed to investigate the mortality rate of pregnant uncorrected congenital heart disease and the impact of pulmonary hypertension severity on mortality. Methods This is the sub study of COngenital HeARt Disease in adult and Pulmonary Hypertension Registry. The data of pregnant uncorrected congenital heart disease patients were analyzed from registry database. The maternal mortality was recorded. The data of demography, clinics, obstetrics, and transthoracic echocardiography were collected. The factors that influenced maternal mortality were analyzed. A statistical significance was determined when p value < 0.05. Results From 2012 until 2017, there were 78 pregnant congenital heart disease patients. Of them, 56 patients were eligible for analyses. The majority of congenital heart disease was atrial septal defect (91.1%). The maternal mortality rate was 10.7% (6 of 56). Pulmonary hypertension occurred in 48 patients, therefore the maternal mortality rate among congenital heart disease-pulmonary hypertension with majority of atrial septal defect was 12.5% (6 of 48). Among nonsurvivors, 100% suffered from severe pulmonary hypertension as compared to survivors (56.0%), p = 0.041. Most nonsurvivors were Eisenmenger syndrome (83.3%), significantly higher compared to survivors (22.0%), p = 0.006. Nonsurvivors had significantly worsened WHO functional class, reduced right ventricle systolic function, and right heart failure. The modes of maternal death were severe oxygen desaturation (66.7%) and respiratory failure and sepsis (33.3%). Most of the maternal deaths occurred within 24 h postpartum period. Conclusion Maternal mortality rate among pregnant uncorrected congenital heart disease with majority of atrial septal defect was 10.7% and among congenital heart disease-pulmonary hypertension with majority of atrial septal defect was 12.5%. Factors related with maternal mortality were severe pulmonary hypertension, Eisenmenger syndrome, and reduced right ventricle systolic function.

Aortic Saturation Predicted Operability in Acyanotic Congenital Heart Disease with Left-to-Right Shunt

2021 ◽  
Vol 104 (5) ◽  
pp. 740-745
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Diagnostic Yield ◽  
Invasive Procedure ◽  
Roc Curve Analysis ◽  
Acyanotic Congenital Heart Disease

Background: Cardiac catheterization is the gold standard to determine operability in patients with congenital heart disease (CHD) with left to right shunt and pulmonary hypertension. Objective: To determine if systemic oxygen saturation could be used as a screening tool for acyanotic CHD patients who are operable without having to undergo an invasive procedure. Materials and Methods: All cardiac catheterization data at the King Chulalongkorn Memorial Hospital between 2002 and 2017 were retrospectively reviewed. The inclusion criteria were acyanotic lesion with left-to-right shunt, mean pulmonary artery pressure of 25 mmHg or more, pulmonary overcirculation (Qp:Qs greater than 1), and absence of significant left sided heart disease (LAP or PCWP of less than 15 mmHg). Operability was defined as Rpi of 6 WU.m² or less and Rp:Rs of less than 0.3 in room air. The value of aortic saturation as diagnostic test for operability was analyzed by ROC curve analysis. Results: Two hundred twenty-six patients, with a median age of two years old, (IQR 0.11, 6.00) were divided into pre-tricuspid shunt (ASD, PAPVR, 9.7%), complete atrioventricular (AV) canal defect (13%), and other post-tricuspid lesion (VSD, PDA, 77%). Aortic saturation cut-off values to predict operability with 100% specificity were 98.5% in pre-tricuspid shunt, 100% in post-tricuspid shunt group, and 94.5% in complete AV canal group. Conclusion: In the present study population, aortic saturation may be used to determine operability in acyanotic CHD patients with pulmonary overcirculation. Diagnostic yield is best in patients with complete AV canal defect in whom oxygen saturation of 95% or above identified operability with close to 100% specificity. In other lesions, there appears to be no oxygen saturation that is safe to preclude cardiac catheterization. Keywords: Congenital heart disease, Acyanotic heart disease, Non-cyanotic heart lesions, Pulmonary hypertension, Operability, Aortic saturation

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