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Aortic Stenosis

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Pregnancy and Congenital Heart Disease

Part of the book series: Congenital Heart Disease in Adolescents and Adults ((CHDAA))

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Abstract

Aortic stenosis is a relatively uncommon heart lesion in women of childbearing age, however, when present, it has been reported to be associated with increased risk of maternal cardiovascular events. The approach to women with aortic stenosis depends on the time of presentation (e.g. prior to pregnancy or during pregnancy). Patient with symptomatic severe aortic stenosis are at the highest risk. Pre pregnancy evaluation including exercise testing is essential. Symptomatic patients should undergo surgery before pregnancy.

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Abbreviations

AoV:

Aortic valve

AS:

Aortic stenosis

AVR:

Aortic valve replacement

CO:

Cardiac output

CW:

Continuous wave

ECG:

Electrocardiography

EF:

Ejection fraction

ET:

Exercise test

FU:

Follow-up

Hb:

Haemoglobin

HR:

Heart rate

MV:

Mitral valve

mWHO:

Modified World Health Organization

ROPAC:

Registry of Pregnancy and Cardiac Disease

SAX:

Short-axis view

SV:

Stroke volume

TTE:

Transthoracic echocardiography

VR:

Vascular resistance

WHO:

World Health Organization

References

  1. Vahanian A, Alfieri O, Andreotti F et al (2012) Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 33:2451–2496. doi:10.1093/eurheartj/ehs109

    Article  PubMed  Google Scholar 

  2. European Society of Gynecology, Association for European Paediatric Cardiology, German Society for Gender Medicine et al (2011) ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J 32:3147–3197. doi:10.1093/eurheartj/ehr218

    Article  Google Scholar 

  3. Silversides CK, Colman JM, Sermer M et al (2003) Early and intermediate-term outcomes of pregnancy with congenital aortic stenosis. Am J Cardiol 91:1386–1389

    Article  PubMed  Google Scholar 

  4. Hameed A, Karaalp IS, Tummala PP (2001) The effect of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol 37:893–899. doi:10.1016/S0735-1097(00)01198-0

    Article  CAS  PubMed  Google Scholar 

  5. Orwat S, Diller GP, Van Hagen IM et al (2015) The risk of pregnancy in aortic stenosis: results from the ROPAC registry. Eur Heart J 36:5

    Google Scholar 

  6. Nora JJ (1994) From generational studies to a multilevel genetic-environmental interaction. JAC 23:1468–1471

    Article  CAS  Google Scholar 

  7. Baumgartner H, Hung J, Bermejo J et al (2009) Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr 22:1–23. doi:10.1016/j.echo.2008.11.029; quiz 101–102

    Article  PubMed  Google Scholar 

  8. Rosenhek R, Klaar U, Schemper M et al (2004) Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J 25:199–205. doi:10.1016/j.ehj.2003.12.002

    Article  PubMed  Google Scholar 

  9. Baumgartner H, Kratzer H, Helmreich G, Kuehn P (1990) Determination of aortic valve area by Doppler echocardiography using the continuity equation: a critical evaluation. Cardiology 77:101–111

    Article  CAS  PubMed  Google Scholar 

  10. Sikka P, Suri V, Aggarwal N et al (2014) Are we missing hypertrophic cardiomyopathy in pregnancy? Experience of a tertiary care hospital. J Clin Diagn Res 8:OC13–OC15. doi:10.7860/JCDR/2014/9924.4803

    PubMed  PubMed Central  Google Scholar 

  11. Ashikhmina E, Farber MK, Mizuguchi KA (2015) Parturients with hypertrophic cardiomyopathy: case series and review of pregnancy outcomes and anesthetic management of labor and delivery. Int J Obstet Anesth 24:344–355. doi:10.1016/j.ijoa.2015.07.002

    Article  CAS  PubMed  Google Scholar 

  12. Drenthen W, Boersma E, Balci A et al (2010) Predictors of pregnancy complications in women with congenital heart disease. Eur Heart J 31:2124–2132. doi:10.1093/eurheartj/ehq200

    Article  PubMed  Google Scholar 

  13. Siu SC, Sermer M, Colman JM et al (2001) Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 104:515–521

    Article  CAS  PubMed  Google Scholar 

  14. Baumgartner H, Bonhoeffer P, De Groot NMS et al (2010) ESC guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 31:2915–2957. doi:10.1093/eurheartj/ehq249

    Article  PubMed  Google Scholar 

  15. Yuan S-M (2014) Bicuspid aortic valve in pregnancy. Taiwan J Obstet Gynecol 53:476–480. doi:10.1016/j.tjog.2013.06.018

    Article  PubMed  Google Scholar 

  16. Savu O, Jurcut R, Giusca S et al (2012) Morphological and functional adaptation of the maternal heart during pregnancy. Circ Cardiovasc Imaging 5:CIRCIMAGING.111.970012–297. doi:10.1161/CIRCIMAGING.111.970012

  17. Roth A, Elkayam U (2008) Acute myocardial infarction associated with pregnancy. J Am Coll Cardiol 52:171–180. doi:10.1016/j.jacc.2008.03.049

    Article  PubMed  Google Scholar 

  18. Tanous D, Siu SC, Mason J et al (2010) B-type natriuretic peptide in pregnant women with heart disease. J Am Coll Cardiol 56:1247–1253. doi:10.1016/j.jacc.2010.02.076

    Article  CAS  PubMed  Google Scholar 

  19. Easterling TR, Chadwick HS, Otto CM (1988) Aortic stenosis in pregnancy. Obstetrics and Gynecology 72(1):113–118

    Google Scholar 

  20. Myerson SG, Mitchell ARJ, Ormerod OJM, Banning AP (2005) What is the role of balloon dilatation for severe aortic stenosis during pregnancy? J Heart Valve Dis 14:147–150

    PubMed  Google Scholar 

  21. Elassy SMR, Elmidany AA, Elbawab HY (2014) Urgent cardiac surgery during pregnancy: a continuous challenge. Ann Thorac Surg 97:1624–1629. doi:10.1016/j.athoracsur.2013.10.067

    Article  PubMed  Google Scholar 

  22. Ayhan A, Yapar EG, Yüce K et al (1991) Pregnancy and its complications after cardiac valve replacement. Int J Gynaecol Obstet 35:117–122

    Article  CAS  PubMed  Google Scholar 

  23. Suri V, Sawhney H, Vasishta K et al (1999) Pregnancy following cardiac valve replacement surgery. Int J Gynaecol Obstet 64:239–246

    Article  CAS  PubMed  Google Scholar 

  24. Leśniak-Sobelga A, Tracz W, KostKiewicz M et al (2004) Clinical and echocardiographic assessment of pregnant women with valvular heart diseases—maternal and fetal outcome. Int J Cardiol 94:15–23. doi:10.1016/j.ijcard.2003.03.017

    Article  PubMed  Google Scholar 

  25. Stott DK, Marpole DGF, Bristow JD et al (1970) The role of left atrial transport in aortic and mitral stenosis. Circulation 41:1031–1041. doi:10.1161/01.CIR.41.6.1031

    Article  CAS  PubMed  Google Scholar 

  26. Salam AM, Ertekin E, van Hagen IM et al (2015) Atrial fibrillation or flutter during pregnancy in patients with structural heart disease: data from the ROPAC. JACC: Clin Electrophysiol. doi:10.1016/j.jacep.2015.04.013

    Google Scholar 

  27. Sliwa K, Johnson MR, Zilla P, Roos-Hesselink JW (2015) Management of valvular disease in pregnancy: a global perspective. Eur Heart J 36:1078–1089. doi:10.1093/eurheartj/ehv050

    Article  PubMed  Google Scholar 

  28. Uebing A, Steer PJ, Yentis SM, Gatzoulis MA (2006) Pregnancy and congenital heart disease. BMJ 332:401–406. doi:10.1136/bmj.332.7538.401

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ruys TPE, Cornette J, Roos-Hesselink JW (2013) Pregnancy and delivery in cardiac disease. J Cardiol 61:107–112. doi:10.1016/j.jjcc.2012.11.001

    Article  PubMed  Google Scholar 

  30. Hunter S, Robson SC (1992) Adaptation of the maternal heart in pregnancy. Br Heart J 68:540–543

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Kaleschke G, Baumgartner H (2011) Pregnancy in congenital and valvular heart disease. Heart 97:1803–1809. doi:10.1136/heartjnl-2011-300369

    Article  PubMed  Google Scholar 

  32. Robson SC, Hunter S, Boys RJ, Dunlop W (1989) Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 256:H1060–H1065

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Division of Adult Congenital and Valvular Heart Disease, University Hospital of Muenster, Münster, Germany

    Stefan Orwat MD & Helmut Baumgartner MD

Authors
  1. Stefan Orwat MD
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  2. Helmut Baumgartner MD
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Corresponding author

Correspondence to Helmut Baumgartner MD .

Editor information

Editors and Affiliations

  1. Erasmus MC University Medical Center, Rotterdam, Gelderland, The Netherlands

    Jolien W. Roos-Hesselink

  2. Chelsea and Westminster Hospital, London, United Kingdom

    Mark R. Johnson

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Orwat, S., Baumgartner, H. (2017). Aortic Stenosis. In: Roos-Hesselink, J., Johnson, M. (eds) Pregnancy and Congenital Heart Disease. Congenital Heart Disease in Adolescents and Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-38913-4_10

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  • DOI: https://doi.org/10.1007/978-3-319-38913-4_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-38911-0

  • Online ISBN: 978-3-319-38913-4

  • eBook Packages: MedicineMedicine (R0)

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