Women who have had an operation in infancy to repair a congenital heart defect can have a successful pregnancy, but it carries a risk of subsequent heart problems, a recent study has found. A fetal deformity called transposition of the great arteries, in which the aorta is connected to the right ventricle of the heart and the pulmonary artery to the left ventricle - instead of vice versa - can be corrected with a surgical procedure called the Mustard operation. Researchers from the Montreal Heart Institute in Quebec, Canada, reviewed the records of 16 women who had undergone the Mustard procedure and had completed 28 pregnancies. They found that six of the women suffered a reduction in functional level during seven pregnancies, and in two cases it did not return to pre-pregnancy levels after delivery. The data also showed that five women suffered enlargement of the right ventricle during seven pregnancies, with no return to pre-pregnancy dimensions at their last examination. The researchers said that it seemed reasonable not to discourage women who have had a Mustard operation from having children, if they have a good exercise capacity, and normal or near normal right ventricle function. These women must, however, be made aware of the possibility of right ventricle dysfunction occurring with pregnancy and that this deterioration may occur during their first pregnancy and that it might not be reversible after delivery.
Journal of the American College of Cardiology,
June 2004