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There is no published evidence on pregnancy after right ventricular outflow tract (RVOT) reconstruction with an allograft.The aim of this study was to describe pregnancy outcomes in women with allografts in the RVOT position.A retrospective cohort study of consecutive female patients who received allografts in the RVOT position was conducted. All patients between 18 and 50 years of age were screened for cardiac, obstetric, and fetal outcomes of completed (≥20 weeks' gestation) pregnancies.In total, 196 women met the inclusion criteria, of whom 56 had 89 completed pregnancies. Information could be retrieved in 84 cases (94.4%). Mean maternal age was 29.6 ± 4.3 years, with 80 patients (95.2%) in New York Heart Association functional class I or II. The most common diagnosis was tetralogy of Fallot. All women survived pregnancy. There were 2 cases (2.4%) of heart failure (arrhythmic and diastolic dysfunction), 1 case (1.2%) of infection (chorioamnionitis), and 3 cases (3.6%) of pre-eclampsia. No other cardiac or obstetric events were reported. All children were born alive at a median gestational age of 38.4 weeks (interquartile range: 36.9 to 39.6 weeks), with a median birthweight of 2,930 g (interquartile range: 2,535 to 3,385 g). Seventeen (20.2%) were small for gestational age, and 20 (23.8%) were premature. Neonatal death was reported in 2 children (2.5%). Preconception pulmonary regurgitation was associated with an increased probability of pre-term labor (odds ratio: 2.610; 95% confidence interval: 1.318 to 5.172). Compared with the general Dutch population, pre-term delivery (25.0% vs. 7.4%, p 0.001) and children small for gestational age (20.2% vs. 10.0%, p = 0.002) were more common.Women in good cardiac health after RVOT reconstruction with allografts can safely experience pregnancy and labor. The higher incidence of pre-term delivery and children small for gestational age warrants special attention.

Successful repair of shunts in patients with congenital heart disease (CHD) is often erroneously considered a cure, leading to a large number of patients lost to follow-up after discharge [(1)][1]. The prevalence of pulmonary hypertension (PH) appears to be high after shunt closure [(2)][2] and is

Endothelin receptor antagonists are regarded a cornerstone in treatment of pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). Currently macitentan, a potential successor of the widely applied bosentan, is being introduced. A recent trial has proven its outstanding

Pulmonary Valve Replacement (PVR) leads to a reduction of right ventricular (RV) volume in tetralogy of Fallot (TOF) but its effects are unknown in patients with isolated pulmonary regurgitation (iPR) after repair of pulmonary stenosis (PS). Our objective was to compare hemodynamic effects of PVR to

Due to advances in surgical and medical care, survival has improved in patients with congenital heart disease (CHD). This has led to an increasing number of surviving patients with systemic to pulmonary shunt, who are at risk of developing pulmonary arterial hypertension (PAH). We aimed to determine

Life-long accumulation of irreversible advanced glycation end-products leads to ventricular stiffening. Endurance training preserves left ventricular compliance. The advanced glycation end-product cross-link breaker Alagebrium (ALT) decreases ventricular stiffness in animal studies. We examined the