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5 results on '"Hudsmith, L."'

1. Direct current cardioversion in pregnancy: a multicentre study.

Author

Cauldwell M, Adamson D, Bhatia K, Bhagra C, Bolger A, Everett T, Fox C, Girling J, Head C, English K, Hudsmith L, James R, Johnson M, MacKiliop L, McAuliffe FM, Mariappa G, Orchard E, O'Brien M, Siddiqui F, Simpson L, Simpson M, Timmons P, Vause S, Wander G, Walker N, and Steer PJ

Subjects
Humans, Female, Pregnancy, Electric Countershock, Treatment Outcome, Retrospective Studies, Atrial Fibrillation, Heart Diseases
Abstract

Objective: Direct current cardioversion (DCCV) in pregnancy is rarely required and typically only documented in single case reports or case series. A recent UK confidential enquiry reported on several maternal deaths where appropriate DCCV appeared to have been withheld., Design: Retrospective cohort study., Setting: Seventeen UK and Ireland specialist maternity centres., Sample: Twenty-seven pregnant women requiring DCCV in pregnancy., Main Outcome Measures: Maternal and fetal outcomes following DCCV., Results: Twenty-seven women had a total of 29 DCCVs in pregnancy. Of these, 19 (70%) initial presentations were to Emergency Departments and eight (30%) to maternity settings. There were no maternal deaths. Seventeen of the women (63%) had a prior history of heart disease. Median gestation at DCCV was 28 weeks, median gestation at delivery was 35 weeks, with a live birth in all cases. The abnormal heart rhythms documented at the first cardioversion were atrial fibrillation in 12/27 (44%) cases, atrial flutter in 8/27 (30%), supraventricular tachycardia in 5/27 (19%) and atrial tachycardia in 2/27 (7%). Fetal monitoring was undertaken following DCCV on 14/29 (48%) occasions (10 of 19 (53%) at ≥26 weeks) and on 2/29 (7%) occasions, urgent delivery was required post DCCV., Conclusions: Direct current cardioversion in pregnancy is rarely required but should be undertaken when clinically indicated according to standard algorithms to optimise maternal wellbeing. Once the woman is stable post DCCV, gestation-relevant fetal monitoring should be undertaken. Maternity units should develop multidisciplinary processes to ensure pregnant women receive the same standard of care as their non-pregnant counterparts., (© 2023 John Wiley & Sons Ltd.)

Published
2023
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2. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease

Author

Van Hagen I. M., Baart S., Fong Soe Khioe R., Sliwa-Hahnle K., Taha N., Lelonek M., Tavazzi L., Maggioni A. P., Johnson M. R., Maniadakis N., Fordham R., Hall R., Roos-Hesselink J. W., Ferrari R., Marelli A., Webb G., Kaemmerer H., Popelova J., Sliwa K., Parsonage W. A., Stein J., Elkayam U., Thilen U., Budts W., Ruys T., Vardas P., Komajda M., Pinto F., Alonso A., Wood D., Ferreira T., Gracia G., Laroche C., Missiamenou V., Taylor C., Konte M., Andarala M., Fiorucci E., Lefrancq E. F., Glemot M., McNeill P-A., Pommier C., Lafay M., Aquieri A., Vega H. R., Blanco M. V., Lust K., Fagermo N., Gabriel H., Donhauser E., Gasimov Z., Jahangirov T., Hasanova I., De Backer J., Demulier L., de Hosson M., Beckx M., Moissens M., Kovacevic-Preradovic T., Kozic M., Lovric M., Freire C. V., Chilingirova N., Kratunkov P., Montesclaros A. R., Beaubien E., Gordon E., Walter L., Lindsay C., Wahab N., Vavera Z., El Nagar A., Ebaid H. H., El Sayed Makled W. A., Dardier A., Shabaan M., Elrakshy Y., Eltamawey K., Abd-El Aziz M. G., Saad A., Aboleineen W., Ashour Z., Sorour K., Mahdy M. A. M., Iserin L., Ladouceur M., Cohen S., Iung B., Maisuradze D., Mebus S., Gembruch U., Hammerstingl C., Merz W. M., Wald C., Baumgartner H., Orwat S., Schmidt R., Motz R., Olsson A., Berger F., Nagdyman N., Frogoudaki A., Anastasiou-Nana M., Temesvari A., Kohalmi D., Balint H., Merkely B., Liptai C., Bowen M., Cullen M., Thornton P., Husarova V., Blatt A., Elbaz-Greener G., Moravsky G., Vered Z., Fuhrmann A. V., Shotan A., Goland S., Festa P., Ali L. A., Sinagra G., Puggia I., Mottolese B. D., Carmina M. G., Romeo C., Crepaz R., Fesslova V., Azzarelli A., Baldi D., Bovenzi F., Donvito V., Vasario E., Todros T., Niwa K., Mussagaliyeva A., Mekebekova D., Sharipova S., Zaliunas R., Jonkaitiene R., Petrauskaite J., Gumbiene L., Jovanova S., Cassar A., Caruana M., Karamermer Y., Cornette J. M. J., van Dijk A., Bellersen L., Duijnhouwer T., De Groot C., Pieper E. P. G., van Oppen C., Polak P., Wajon E., Wagenaar L., Estensen M., Lesniak-Sobelga A., Podolec P., Wisniowska-Smialek S., Trybuch A., Hoffman P., Cichocka-Radwan A., Sobczak S., Faflik U., Tomaszuk-Kazberuk A., Przepiesc J., Gil M., Plaskota K., Trojnarska O., Guerra N., de Sousa L., Petrescu V., Ginghina C., Jurcut R., Coman I. M., Gaisin I. R., Shilina L. V., Sharashkina N., Tkacheva O., Ivanov D., Irtyuga O., Jovovic L., Prokselj K., Kozelj M., Elliott C., Galian-Gay L., Pijuan-Domenech A., Subirana-Domenech M. T., Tornos P., Murga N., Oliver J. M., Escribano-Subias P., Ruiz-Cano M. J., Delgado-Jimenez J., Furenas E., Dellborg M., Schwerzmann M., Bouchardy J., Rutz T., Tobler D., Sarac L., Esen O. B., Enar S. C., Al Mulla A., Bazargani N., Al Hatou E., Farook F., Almahmeed W., Salih B., Clifford P., Bowers N., Veldtman G., Kerr J., Tellett L., Hudsmith L., Thompson P., Thorne S., Bowater S., Nihoyannopoulos P., Curry R., Freeman L., Schroeder F., Wendler R., Hammond S., Talluto C., Murphy D., Perlroth M. G., Chintala K., Gupta P., Pare E., Khatri N., Scott N., De Faria-Yeh D., Bhatt A. B., Tsiaras S., Gurvitz M., Otto C., Botti J., Ting J., Davidson W. R., Cardiology, Van Hagen, I. M., Baart, S., Fong Soe Khioe, R., Sliwa-Hahnle, K., Taha, N., Lelonek, M., Tavazzi, L., Maggioni, A. P., Johnson, M. R., Maniadakis, N., Fordham, R., Hall, R., Roos-Hesselink, J. W., Ferrari, R., Marelli, A., Webb, G., Kaemmerer, H., Popelova, J., Sliwa, K., Parsonage, W. A., Stein, J., Elkayam, U., Thilen, U., Budts, W., Ruys, T., Vardas, P., Komajda, M., Pinto, F., Alonso, A., Wood, D., Ferreira, T., Gracia, G., Laroche, C., Missiamenou, V., Taylor, C., Konte, M., Andarala, M., Fiorucci, E., Lefrancq, E. F., Glemot, M., Mcneill, P-A., Pommier, C., Lafay, M., Aquieri, A., Vega, H. R., Blanco, M. V., Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. V., Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. G., Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A. M., Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. V., Shotan, A., Goland, S., Festa, P., Ali, L. A., Sinagra, G., Puggia, I., Mottolese, B. D., Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M. J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P. G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. M., Gaisin, I. R., Shilina, L. V., Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subias, P., Ruiz-Cano, M. J., Delgado-Jimenez, J., Furenas, E., Dellborg, M., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. B., Enar, S. C., Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Subjects
Registrie, Pediatrics, Cardiac & Cardiovascular Systems, Heart disease, global health, heart failure, Disease, 030204 cardiovascular system & hematology, Cardiovascular, 0302 clinical medicine, Pregnancy, Residence Characteristics, Prospective Studies, Registries, PREDICTORS, 1102 Cardiorespiratory Medicine and Haematology, CARDIOLOGY, 030219 obstetrics & reproductive medicine, valvular heart disease, Pregnancy Outcome, SOUTH-AFRICA, congenital heart disease, pregnancy, Adult, Analysis of Variance, Female, Global Health, Heart Diseases, Humans, Maternal Age, Pregnancy Complications, Cardiovascular, Socioeconomic Factors, EUROPEAN-SOCIETY, Heart Disease, CARDIOVASCULAR-DISEASE, RISK-ASSESSMENT, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, Human, Acute coronary syndrome, medicine.medical_specialty, ROPAC investigators, Birth rate, 03 medical and health sciences, medicine, CARDIAC-DISEASE, MATERNAL OUTCOMES, Socioeconomic status, Science & Technology, business.industry, INCOME INEQUALITY, medicine.disease, Pregnancy Complications, Prospective Studie, Cardiovascular System & Hematology, Residence Characteristic, Heart failure, REGISTRY, Cardiovascular System & Cardiology, business
Abstract

ObjectiveCardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.MethodsThe Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient–centre–country).ResultsA total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.ConclusionWhile there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome.

Published
2018

3. IMAGES IN CARDIOLOGY: Cervical extradural haematoma following thrombolysis.

Author

Haldar, S., Hudsmith, L., and Munir, S.

Subjects
*THROMBOLYTIC therapy, *CHEST disease diagnosis, *ELECTROCARDIOGRAPHY, *HEART diseases, *CORONARY arteries, *BLOOD vessels
Abstract

This article presents information on a medical case related to cervical extradural haematoma following thrombolysis. A previously well 53 year old man presented with a three hour history of severe chest pain. An ECG showed 4 mm ST segment elevation in the anterior leads. He received reteplase and clopidogrel. The patient was transferred as an emergency to the local neuro surgical centre where he underwent emergency evacuation of the haematoma. Seven days later, he had ongoing chest pain with dynamic ECG changes and underwent successful angioplasty to his left anterior descending coronary artery.

Published
2005
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4. REDUCING THE RISK OF NON-CARDIAC SURGERY -- ARE WE USING β BLOCKERS ROUTINELY?

Author

Dering, A., Hudsmith, L. E., McKenna, C. J., Ewart, M., and Orr, W. P.

Subjects
*CARDIOVASCULAR diseases, *BLOOD circulation disorders, *HEART diseases, *CARDIAC surgery, *CARDIOLOGISTS, *VASCULAR surgery
Abstract

The article focuses on a study to assess patients with cardiovascular disease undergoing moderate/high risk non-cardiac surgery has become a significant part of cardiology practice in recent years. Good communication between cardiologist, anesthetist, and surgeon is necessary if this is to be done well. An increasing body of evidence now guides practice especially with respect to the use of peri-operative β blockade. Achieving adequate β blockade for major vascular surgery has been reported to reduce operative risk by as much as 90%, and there is evidence that stopping already established β blockers at the time of surgery significantly increases risk. Despite this, researchers were aware that routine use of β blockers in this setting is not yet standard.

Published
2004

5. Pregnancy outcome in thoracic aortic disease data from the Registry Of Pregnancy And Cardiac disease

Author

Jasmine Grewal, Lucia Baris, Jolien W Roos-Hesselink, Julie De Backer, Laurence Campens, Guillaume Jondeau, Antione Bondue, Mark R. Johnson, Craig S. Broberg, Nandita S. Scott, Roger Hall, Cardiology, Aquieri, A., Saad, A., Ruda Vega, H., Hojman, J., Caparros, J M, Vazquez Blanco, M., Arstall, M., Chung, C M, Mahadavan, G., Aldridge, E., Wittwer, M., Chow, Y Y, Parsonage, W A, Lust, K., Collins, N., Warner, G., Hatton, R., Gordon, A., Nyman, E., Stein, J., Donhauser, E., Gabriel, H., Bahshaliyev, A., Guliyev, F., Hasanova, I., Jahangirov, T., Gasimov, Z., Salim, A., Ahmed, C M, Begum, F., Mahmood, M., Islam, M N, Haque, P P, Banerjee, S K, Parveen, T., Morissens, M., De Backer, J., Demulier, L., de Hosson, M., Budts, W., Beckx, M., Kozic, M., Lovric, M., Kovacevic-Preradovic, T., Chilingirova, N., Kratunkov, P., Wahab, N., Gordon, E., Walter, L., Marelli, A., Montesclaros, A R, Monsalve, G., Rodriguez, C., Balthazar, F., Quintero, V., Palacio, W., Mejía Cadavid, L A, Munoz Ortiz, E., Fortich Hoyos, F., Arevalo Guerrero, E., Gandara Ricardo, J., Velasquez Penagos, J., Vavera, Z., Popelova, J., Vejlstrup, N., Grønbeck, L., Johansen, M., Ersboll, A., Elrakshy, Y., Eltamawy, K., Gamal Abd-El Aziz, M., El Nagar, A., Ebaid, H., Abo Elenin, H., Saed, M., Farag, S., Makled, W., Sorour, K., Ashour, Z., El-Sayed, G., Abdel Meguid Mahdy, M., Taha, N., Dardeer, A., Shabaan, M., Ali, M., Moceri, P., Duthoit, G., Gouton, M., Nizard, J., Baris, L., Cohen, S., Ladouceur, M., Khimoud, D., Iung, B., Berger, F., Olsson, A., Gembruch, U., Merz, W M, Reinert, E., Clade, S., Kliesch, Y., Sinning, C., Kozlik-Feldmann, R., Blankenberg, S., Zengin-Sahm, E., Mueller, G., Hillebrand, M., Hauck, P., von Kodolitsch, Y., Zarniko, N., Baumgartner, H., Hellige, A., Tutarel, O., Kaemmerer, H., Kuschel, B., Motz, R., Maisuradze, D., Frogoudaki, A., Iliodromitis, E., Anastasiou-Nana, M., Marousi, D., Triantafyllis, G., Bekiaris, H., Karvounis, G., Giannakoulas, D., Ntiloudi, S A, Mouratoglou, A., Temesvari, H Balint, Kohalmi, D., Merkely, B., Liptai, C., Nemes, A., Forster, T., Kalapos, A., Berek, K., Havasi, K., Ambrus, N., Shelke, A., Patil, S., Martanto, E., Aprami, T M, Purnomowati, A., Cool, C J, Hasan, M., Akbar, R., Hidayat, S., Dewi, T I, Permadi, W., Soedarsono, D A, Ansari-Ramandi, M M, Samiei, N., Tabib, A., Kashfi, F., Ansari-Ramandi, S., Rezaei, S., Ali Farhan, H., Al-Hussein, A., Al-Saedi, G., Mahmood, G., Yaseen, I F, Al-Yousuf, L., AlBayati, M., Mahmood, S., Raheem, S., AlHaidari, T., Dakhil, Z., Thornton, P., Donnelly, J., Bowen, M., Blatt, A., Elbaz-Greener, G., Shotan, A., Yalonetsky, S., Goland, S., Biener, M., Egidy Assenza, G., Bonvicini, M., Donti, A., Bulgarelli, A., Prandstraller, D., Romeo, C., Crepaz, R., Sciatti, E., Metra, M., Orabona, R., Ait Ali, L., Festa, P., Fesslova, V., Bonanomi, C., Calcagnino, M., Lombardi, F., Colli, A M, Ossola, M W, Gobbi, C., Gherbesi, E., Tondi, L., Schiavone, M., Squillace, M., Carmina, M G, Maina, A., Macchi, C., Gollo, E., Comoglio, F M, Montali, N., Re, P., Bordese, R., Todros, T., Donvito, V., Grosso Marra, W., Sinagra, G., D'Agata Mottolese, B., Bobbo, M., Gesuete, V., Rakar, S., Ramani, F., Niwa, K., Mekebekova, D., Mussagaliyeva, A., Lee, T., Mirrakhimov, E., Abilova, S., Bektasheva, E., Neronova, K., Lunegova, O., Žaliūnas, R., Jonkaitienė, R., Petrauskaitė, J., Laucevičius, Aleksandras, Žebrauskienė, Dovilė, Laučiuvienė, Laimutė, Gumbienė, Lina, Lankutienė, Lina, Glaveckaitė, Sigita, Laukytė, Monika, Solovjova, Svetlana, Rudienė, Virginija, C C-W, Yim, Ang, H L, Kuppusamy, R., Watson, T., Caruana, M., Estensen, M-E, Mahmood Kayani, M G A, Munir, R., Sobkowicz, B., Przepiesc, J., Lesniak-Sobelga, A., Tomkiewicz-Pajak, L., Komar, M., Olszowska, M., Podolec, P., Wisniowska-Smialek, S., Lelonek, M., Faflik, U., Cichocka-Radwan, A., Plaskota, K., Trojnarska, O., de Sousa, L., Cruz, C., Ribeiro, V., Jovanova, S., Petrescu, V., Jurcut, R., Ginghina, C., Mircea Coman, I., Musteata, M., Osipova, O., Golivets, T., Khamnagadaev, I., Golovchenko, O., Nagibina, A., Ropatko, I., Gaisin, I R, Valeryevna Shilina, L., Sharashkina, N., Shlyakhto, E., Irtyuga, O., Moiseeva, O., Karelkina, E., Zazerskaya, I., Kozlenok, A., Sukhova, I., Jovovic, L., Prokšelj, K., Koželj, M., Askar, A O, Abdilaahi, A A, Mohamed, M H, Sliwa, K., Manga, P., Galian-Gay, L., Tornos, P., Subirana, M T, Murga, N., Oliver, J M, Garcia-Aranda Dominguez, B., Hernandez Gonzalez, I., Escribano Subias, P., Elbushi, A., Suliman, A., Jazzar, K., Murtada, M., Ahamed, N., Dellborg, M., Furenas, E., Jinesjo, M., Skoglund, K., Eriksson, P., Gilljam, T., Thilen, U., Tobler, D., Wustmann, K., Schwitz, F., Schwerzmann, M., Rutz, T., Bouchardy, J., Greutmann, M., Santos Lopes, B M, Meier, L., Arrigo, M., de Boer, K., Konings, T., Wajon, E., Wagenaar, L J, Polak, P., Pieper, E Pg, Roos-Hesselink, J., van Hagen, I., Duvekot, H., Cornette, J M J, De Groot, C., van Oppen, C., Sarac, L., Batukan Esen, O., Catirli Enar, S., Mondo, C., Ingabire, P., Nalwanga, B., Semu, T., Salih, B T, Almahmeed, W A R, Wani, S., Mohamed Farook, F S, Al Ain, F Gerges, Gerges, F., Komaranchath, A M, Al Bakshi, F., Al Mulla, A., Yusufali, A H, Al Hatou, E I, Bazargani, N., Hussain, F., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Money-Kyrle, A., Clifford, P., Ramrakha, P., Firoozan, S., Chaplin, J., Bowers, N., Adamson, D., Schroeder, F., Wendler, R., Nihoyannopoulos, P., Hall, R., Freeman, L., Veldtman, G., Kerr, J., Tellett, L., Scott, N., Bhatt, A B, DeFaria Yeh, D., Youniss, M A, Wood, M., Sarma, A A, Tsiaras, S., Stefanescu, A., Duran, J M, Stone, L., Majdalany, D S, Chapa, J., Chintala, K., Gupta, P., Botti, J., Ting, J., Davidson, W R, Wells, G., Sparks, D., Paruchuri, V., Marzo, K., Patel, D., Wagner, W., Ahanya, S N, Colicchia, L., Jentink, T., Han, K., Loichinger, M., Parker, M., Longtin, C., Yetman, A., Erickson, K., Tsai, S., Fletcher, B., Warta, S., Cohen, C., Lindblade, C., Puntel, R., Nagaran, K., Croft, N., Gurvitz, M., Otto, C., Talluto, C., Murphy, D., Perlroth, M G, and Jančauskaitė, Dovilė

Subjects
Marfan syndrome, Heart malformation, Aorta, Thoracic, Comorbidity, 030204 cardiovascular system & hematology, Global Health, Aortic aneurysm, 0302 clinical medicine, Bicuspid aortic valve, Pregnancy, Cause of Death, Turner syndrome, Medicine and Health Sciences, Prospective Studies, Registries, DISSECTION, Cause of death, Aortic dissection, 030219 obstetrics & reproductive medicine, Incidence, Pregnancy Outcome, WOMEN, Aortic and Vascular Disease, MARFAN-SYNDROME, Survival Rate, Marfan and associated disorders, aortic and arterial disease, aortic aneurysm, bicuspid aortic valve, pregnancy, Cardiology, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Heart Diseases, Pregnancy Complications, Cardiovascular, Aortic Diseases, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Humans, business.industry, Infant, Newborn, medicine.disease, business
Abstract

BackgroundCardiovascular disease is the leading cause of death during pregnancy with thoracic aortic dissection being one of the main causes. Thoracic aortic disease is commonly related to hereditary disorders and congenital heart malformations such as bicuspid aortic valve (BAV). Pregnancy is considered a high risk period in women with underlying aortopathy.MethodsThe ESC EORP Registry Of Pregnancy And Cardiac disease (ROPAC) is a prospective global registry that enrolled 5739 women with pre-existing cardiac disease. With this analysis, we aim to study the maternal and fetal outcome of pregnancy in women with thoracic aortic disease.ResultsThoracic aortic disease was reported in 189 women (3.3%). Half of them were patients with Marfan syndrome (MFS), 26% had a BAV, 8% Turner syndrome, 2% vascular Ehlers-Danlos syndrome and 11% had no underlying genetic defect or associated congenital heart defect. Aortic dilatation was reported in 58% of patients and 6% had a history of aortic dissection. Four patients, of whom three were patients with MFS, had an acute aortic dissection (three type A and one type B aortic dissection) without maternal or fetal mortality. No complications occurred in women with a history of aortic dissection. There was no significant difference in median fetal birth weight if treated with a beta-blocker or not (2960 g (2358–3390 g) vs 3270 g (2750–3570 g), p value 0.25).ConclusionThis ancillary analysis provides the largest prospective data review on pregnancy risk for patients with thoracic aortic disease. Overall pregnancy outcomes in women with thoracic aortic disease followed according to current guidelines are good.

Published
2021

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