Abstract
Congenital heart disease represent a large proportion of heart disease in pregnancy. With the exception of patients with Eisenmenger’s syndrome, pulmonary vascular obstructive disease, and Marfan’s syndrome with aortopathy, maternal death during pregnancy is rare in women with CHD but morbidity occurs such as heart failure, arrhythmias, and stroke. Echocardiography represents a milestone in diagnosis, understanding of pathophysiology, assessment of disease severity and patient monitoring in pregnant women with unoperated and post-operative congenital heart disease.
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Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC, Kells CM, Bergin ML, Kiess MC, Marcotte F, Taylor DA, Gordon EP, Spears JC, Tam JW, Amankwah KS, Smallhorn JF, Farine D, Sorensen S, Cardiac Disease in Pregnancy (CARPREG) Investigators (2001) Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 104:515–521
Jastrow N, Meyer P, Khairy P, Mercier LA, Dore A, Marcotte F, Leduc L (2010) Prediction of complications in pregnant women with cardiac diseases referred to a tertiary center. Int J Cardiol [Epub ahead of print]
Khairy P, Ouyang DW, Fernandes SM, Lee-Parritz A, Economy KE, Landzberg MJ (2006) Pregnancy outcomes in women with congenital heart disease. Circulation 113:517–524
Drenthen W, Pieper PG, Roos-Hesselink JW, van Lottum WA, Voors AA, Mulder BJ, van Dijk AP, Vliegen HW, Yap SC, Moons P, Ebels T, van Veldhuisen DJ, ZAHARA Investigators (2007) Outcome of pregnancy in women with congenital heart disease: a literature review. J Am Coll Cardiol 49:2303–2311
Tsiaras S, Poppas A (2010) Cardiac disease in pregnancy: value of echocardiography. Curr Cardiol Rep 12:250–256
Mertens L, Friedberg MK (2009) The gold standard for noninvasive imaging in congenital heart disease: echocardiography. Curr Opin Cardiol 24:119–124
Spaanderman ME, Meertens M, van Bussel M, Ekhart TH, Peeters LL (2000) Cardiac output increases independently of basal metabolic rate in early human pregnancy. Am J Physiol Heart Circ Physiol 278:H1585–H1588
Duvekot JJ, Peeters LL (1994) Maternal cardiovascular hemodynamic adaptation to pregnancy. Obstet Gynecol Surv 49(Suppl 12):S1–S14
Campos O (1996) Doppler echocardiography during pregnancy: physiological and abnormal findings. Echocardiogr 13:135–146
Desai DK, Moodley J, Naidoo DP (2004) Echocardiographic assessment of cardiovascular hemodynamics in normal pregnancy. Obstet Gynecol 104:20–29
Mone SM, Sanders SP, Colan SD (1996) Control mechanisms for physiological hypertrophy of pregnancy. Circulation 94:667–672
Schannwell CM, Zimmermann T, Schneppenheim M (2002) Left ventricular hypertrophy and diastolic dysfunction in healthy pregnant women. Cardiology 97:73–78
Bamfo JE, Kametas NA, Nicolaides KH, Chambers JB (2007) Maternal left ventricular diastolic and systolic long-axis function during normal pregnancy. Eur J Echocardiogr 8:360–368
Simmons LA, Gillin AG, Jeremy RW (2002) Structural and functional changes in left ventricle during normotensive and preeclamptic pregnancy. Am J Physiol Heart Circ Physiol 283:H1627–H1633
Moran AM, Colan SD, Mauer MB, Geva T (2002) Adaptive mechanisms of left ventricular diastolic function to the physiologic load of pregnancy. Clin Cardiol 25:124–131
Bamfo JE, Kametas NA, Nicolaides KH, Chambers JB (2007) Reference ranges for tissue Doppler measures of maternal systolic and diastolic left ventricular function. Ultrasound Obstet Gynecol 29:414–420
Vasapollo B, Novelli GP, Valensise H (2008) Total vascular resistance and left ventricular morphology as screening tools for complications in pregnancy. Hypertension 51:1020–1026
Otto CM (2000) Timing of aortic surgery. Heart 84:211–218
Daliento L, Somerville J, Presbitero P, Menti L, Brach-Prever S, Rizzoli G, Stone S (1998) Eisenmenger syndrome. Factors relating to deterioration and death. Eur Heart J 19:1845–1855
Yap SC, Drenthen W, Meijboom FJ, Moons P, Mulder BJ, Vliegen HW, van Dijk AP, Jaddoe VW, Steegers EA, Roos-Hesselink JW, Pieper PG, ZAHARA investigators (2009) Comparison of pregnancy outcomes in women with repaired versus unrepaired atrial septal defect. BJOG 116:1593–1601
Yap SC, Drenthen W, Pieper PG, Moons P, Mulder BJ, Vliegen HW, van Dijk AP, Meijboom FJ, Jaddoe VW, Steegers EA, Boersma E, Roos-Hesselink JW, on behalf of the ZAHARA investigators (2010) Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect. BJOG 117:683–689
Ou TY, Chen RF, Hsu C, Kao P, Yu F, Teng S, Lee W (2009) Pulmonary valve endocarditis in a pregnant woman with a ventricular septal defect. J Microbiol Immunol Infect 42:92–95
Drenthen W, Pieper PG, van der Tuuk K, Roos-Hesselink JW, Voors AA, Mostert B, Mulder BJ, Moons P, Ebels T, van Veldhuisen DJ, Zahara Investigators (2005) Cardiac complications relating to pregnancy and recurrence of disease in the offspring of women with atrioventricular septal defects. Eur Heart J 26:2581–2587
Mohapatra S, Minhas HS, Virmani S, Mishra BB, Mukherjee K, Banerjee A (2009) Acquired left atrial-to-right ventricular shunt with mitral valve incompetence: a rare sequela after repair of atrioventricular septal defect. Tex Heart Inst J 36:69–71
Kouris NT, Sifaki MD, Kontogianni DD, Zaharos I, Kalkandi EM, Grassos HE, Babalis DK (2003) Patent ductus arteriosus endarteritis in a 40-year old woman, diagnosed with transesophageal echocardiography. A case report and a brief review of the literature. Cardiovasc Ultrasound 1:2–7
Shabbir M, Ahmed W, Qureshi O, Ali J (2008) Closure of patent ductus arteriosus by transcatheter technique in a pregnant patient. J Pak Med Assoc 58:709–710
Elkayam U, Bitar F (2005) Valvular heart disease and pregnancy part I: native valves. J Am Coll Cardiol 46:223–230
Lesniak-Sobelga A, Tracz W, Kost Kiewicz M, Podolec P, Pasowicz M (2004) Clinical and echocardiographic assessment of pregnant women with valvular heart diseases–maternal and fetal outcome. Int J Cardiol 94:15–23
Rayburn WF, LeMire MS, Bird JL, Buda AJ (1987) Mitral valve prolapse. Echocardiographic changes during pregnancy. J Reprod Med 32:185–187
Davlouros PA, Koutsogiannis N, Karatza A, Alexopoulos D (2009) An unusual case of cor triatriatum sinister presenting as pulmonary oedema during labor. Int J Cardiol (Epub ahead of print)
Bai W, Kaushal S, Malviya S, Griffith K, Ohye RG (2010) Anesthetic management for resection of cor triatriatum during the second trimester of pregnancy. Int J Obstet Anesth 19:103–106
Yap S, Drenthen W, Pieper PG, Moons P, Mulder BJM, Mostert B, Vliegen HW, van Dijk APJ, Meijboom FJ, Steegers EAP, Roos-Hesselink JW, On behalf of the ZAHARA investigators (2008) Risk of complications during pregnancy in women with congenital aortic stenosis. Int J Cardiol 126:240–246
Tzemos N, Silversides CK, Colman JM, Therrien J, Webb GD, Mason J, Cocoara E, Sermer M, Siu SC (2009) Late cardiac outcomes after pregnancy in women with congenital aortic stenosis. Am Heart J 157:474–480
Vitarelli A, Cortes Morichetti M, Conde Y, Cimino E, D’Orazio S, Stellato S, Padella V, Caranci F, Battaglia D (2007) Assessment of severity in aortic stenosis–Incremental value of endocardial function parameters compared to standard indexes. Ultrasound Med Biol 33:1224–1235
Tzemos N, Silversides CK, Carasso S, Rakowski H, Siu SC (2008) Effect of pregnancy on left ventricular motion (twist) in women with aortic stenosis. Am J Cardiol 101:870–873
Hameed AB, Goodwin TM, Elkayam U (2007) Effect of pulmonary stenosis on pregnancy outcomes–a case-control study. Am Heart J 154:852–854
Drenthen W, Pieper PG, Roos-Hesselink JW, Schmidt ACM, Mulder BJM, van Dijk APJ, Vliegen HW, Sollie KM, Voors AA, Ebels T, van Veldhuisen DJ, on behalf of the ZAHARA investigators (2006) Non-cardiac complications during pregnancy in women with isolated congenital pulmonary valvar stenosis. Heart 92:1838–1843
Vriend JWJ, Drenthen W, Pieper PG, Roos-Hesselink GW, Zwinderman AH, van Veldhuisen DJ, Mulder BJM, on behalf of the ZAHARA investigators (2005) Outcome of pregnancy in patients after repair of aortic coarctation. Eur Heart J 26:2173–2178
Beauchesne LM, Connolly HM, Ammash NM, Warnes CA (2001) Coarctation of the aorta: outcome of pregnancy. J Am Coll Cardiol 38:1728–1733
Vriend JW, Drenthen W, Pieper PG, Roos-Hesselink JW, Zwinderman AH, van Veldhuisen DJ, Mulder BJ (2005) Outcome of pregnancy in patients after repair of aortic coarctation. Eur Heart J 26:2173–2178
Avanzas P, Garcìa-Fernàndez MA, Quiles J, Datino T, Moreno M (2004) Pseudoaneurysm complicating aortic coarctation in a pregnant woman. Int J Cardiol 97:157–158
Kelly D, Amadi A (2005) Serial pressure gradients across a thoracic coarctation of the aorta during pregnancy. Eur J Echocardiogr 6:288–290
Vitarelli A, Conde Y, Cimino E, D’Orazio S, Stellato S, Battaglia D, Padella V, Caranci F, Continanza G, Dettori O, Capotosto L (2008) Assessment of ascending aorta distensibility after successful coarctation repair by strain Doppler echocardiography. J Am Soc Echocardiogr 21:729–736
Hager A, Kaemmerer H, Leppert A, Prokop M, Blücher S, Stern H, Hess J (2005) Follow-up of adults with coarctation of aorta: Comparison of helical CT scanning and MRI, and impact on assessing diameter changes. Chest 126:1169–1176
Goland S, Barakat M, Khatri N, Elkayam U (2009) Pregnancy in Marfan syndrome: maternal and fetal risk and recommendations for patient assessment and management. Cardiol Rev 17:253–262
Rossiter JP, Repke JT, Morales AJ, Murphy EA, Pyeritz RE (1995) A prospective longitudinal evaluation of pregnancy in the Marfan syndrome. Am J Obstet Gynecol 173:1599–1606
Meijboom LJ, Drenthen W, Pieper PG, Groenink M, van der Post JA, Timmermans J, Voors AA, Roos-Hesselink JW, van Veldhuisen DJ, Mulder BJ, ZAHARA investigators (2006) Obstetric complications in Marfan syndrome. Int J Cardiol 110:53–59
Sakaguchi M, Kitahara H, Seto T, Furusawa T, Fukui D, Yanagiya N, Nishimura K, Amano J (2005) Surgery for acute type A aortic dissection in pregnant patients with Marfan syndrome. Eur J Cardiothorac Surg 28:280–283
Vitarelli A, Conde Y, Cimino E, D’Angeli I, D’Orazio S, Stellato S, Padella V, Caranci F (2006) Assessment of aortic wall mechanics in Marfan syndrome by transesophageal tissue Doppler echocardiography. Am J Cardiol 97:571–577
Therrien J, Barnes I, Somerville J (1999) Outcome of pregnancy in patients with congenitally corrected transposition of the great arteries. Am J Cardiol 84:820–824
Connolly HM, Grogan M, Warnes CA (1999) Pregnancy among women with congenitally corrected transposition of great arteries. J Am Coll Cardiol 33:1692–1695
Van de Veire NR, Blom NA, Holman ER, Schalij MJ, Bax JJ (2007) Triplane tissue Doppler imaging to evaluate mechanical dyssynchrony before and after cardiac resynchronization in a patient with congenitally corrected transposition of the great arteries. J Cardiovasc Electrophysiol 18:222–225
Ly M, Belli E, Leobon B, Kortas C, Grollmuss OE, Piot D, Planché C, Serraf A (2009) Results of the double switch operation for congenitally corrected transposition of the great arteries. Eur J Cardiothor Surg 35:879–884
Connolly HM, Warnes CA (1994) Ebstein’s anomaly: outcome of pregnancy. J Am Coll Cardiol 23:1194–1198
Chopra S, Suri V, Aggarwal N, Rohilla M, Vijayvergiya R, Keepanasseril A (2010) Ebstein’s anomaly in pregnancy: maternal and neonatal outcomes. J Obstet Gynaecol Res 36:278–283
Attenhofer Jost CH, Connolly HM, Dearani JA, Edwards WD, Danielson GK (2007) Ebstein’s anomaly. Circulation 115:277–285
Sinto R, Nasution SA (2009) Pregnancy in a woman with uncorrected tetralogy of Fallot. Acta Med Indones 41:81–86
Meijer JM, Pieper PG, Drenthen W, Voors AA, Roos-Hesselink JW, van Dijk AP, Mulder BJ, Ebels T, van Veldhuisen DJ (2005) Pregnancy, fertility, and recurrence risk in corrected tetralogy of Fallot. Heart 91:801–805
Iriart X, Montaudon M, Lafitte S, Chabaneix J, Réant P, Balbach T, Houle H, Laurent F, Thambo JB (2009) Right ventricle three-dimensional echography in corrected tetralogy of Fallot: accuracy and variability. Eur J Echocardiogr 10:784–792
D’Andrea A, Caso P, Sarubbia B, Russo MG, Ascione L, Scherillo M, Cotrufo M, Calabro` R (2004) Right ventricular myocardial dysfunction in adult patients late after repair of tetralogy of Fallot. Int J Cardiol 94:213–220
Davlouros PA, Kilner PJ, Hornung TS, Li W, Francis JM, Moon JC, Smith GC, Tat T, Pennell DJ, Gatzoulis MA (2002) Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 40:2044–2052
Cheung EWY, Liang X, Lam WWM, Yiu-Fai Cheung Y (2009) Impact of right ventricular dilation on left ventricular myocardial deformation in patients after surgical repair of tetralogy of Fallot. Am J Cardiol 104:1264–1270
Uebing A, Arvanitis P, Li W, Diller GP, Babu-Narayan SV, Okonko D, Koltsida E, Papadopoulos M, Johnson MR, Lupton MG, Yentis SM, Steer PJ, Gatzoulis MA (2010) Effect of pregnancy on clinical status and ventricular function in women with heart disease. Int J Cardiol 139:50–59
Grotenhuis HB, Ottenkamp J, de Bruijn L, Westenberg JJM, Vliegen HW, Kroft LJM, de Roos A (2009) Aortic elasticity and size are associated with aortic regurgitation and left ventricular dysfunction in tetralogy of Fallot after pulmonary valve replacement. Heart 95:1931–1936
Drenthen W, Pieper PG, Zoon N, Roos-Hesselink JW, Voors AA, Mulder BJ, van Dijk AP, Sollie KM, Vliegen HW, Ebels T, van Veldhuisen DJ, ZAHARA Investigators (2006) Pregnancy after biventricular repair for pulmonary atresia with ventricular septal defect. Am J Cardiol 98:262–266
Drenthen W, Pieper PG, van der Tuuk K, Roos-Hesselink JW, Hoendermis ES, Voors AA, Mulder BJ, van Dijk AP, Yap SC, Vliegen HW, Moons P, Ebels T, van Veldhuisen DJ (2008) Fertility, pregnancy and delivery in women after biventricular repair for double outlet right ventricle. Cardiology 109:105–109
Aboulhosn J, Child JS (2007) The adult with a Fontan operation. Curr Cardiol Rep 9:331–335
Cheung YF, Penny DJ, Redington AN (2000) Serial assessement of left ventricular diastolic function after Fontan procedure. Heart 83:420–424
Vitarelli A, Conde Y, Cimino E, D’Angeli I, D’Orazio S, Ventriglia F, Bosco G, Colloridi V (2005) Quantitative assessment of systolic and diastolic ventricular function with tissue Doppler imaging after Fontan type of operation. Int J Cardiol 102:61–69
Drenthen W, Pieper PG, Roos-Hesselink JW, van Lottum WA, Voors AA, Mulder BJ, van Dijk AP, Vliegen HW, Sollie KM, Moons P, Ebels T, van Veldhuisen DJ, ZAHARA Investigators (2006) Pregnancy and delivery in women after Fontan palliation. Heart 92:1290–1294
Balling G, Vogt M, Kaemmerer H, Eicken A, Meisner H, Hess J (2000) Intracardiac thrombus formation after the Fontan operation. J Thorac Cardiovasc Surg 119:745–752
Love BA, Mehta M, Fuster VF (2008) Evaluation and management of the adult patient with transposition of the great arteries following atrial-level (Senning or Mustard) repair. Nat Clin Pract Cardiovasc Med 5:454–467
Klein AJ, Kim MS, Salcedo E, Fagan T, Kay J (2009) The missing leak: a case report of a baffle-leak closure using real-time 3D transoesophageal guidance. Eur J Echocardiogr 10:464–467
Canobbio MM, Morris CD, Graham TP, Landzberg MJ (2006) Pregnancy outcomes after atrial repair for transposition of the great arteries. Am J Cardiol 98:668–672
Drenthen W, Pieper PG, Ploeg M, Voors AA, Roos-Hesselink JW, Mulder BJM, Vliegen HW, Sollie KM, Ebels T, van Veldhuisen DJ, on behalf of the ZAHARA investigators (2005) Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries. Eur Heart J 26:2588–2595
Millane T, Bernard EJ, Jaeggi E, Howman-Giles RB, Uren RF, Cartmill TB, Hawker RE, Celermajer DS (2000) Role of ischemia and infarction in late right ventricular dysfunction after atrial repair of transposition of the great arteries. J Am Coll Cardiol 35:1661–1668
Malik P, Therrien J, Webb GD (2002) Acute myocardial infarction late after Mustard procedure for dextrotransposition of the great arteries. Can J Cardiol 18:187–191
Chow P, Liang X, Lam WWM, Cheung EWY, Wong K, Cheung Y (2008) Mechanical right ventricular dyssynchrony in patients after atrial switch operation for transposition of the great arteries. Am J Cardiol 101:874–881
Zartner PA, Wiebe W, Volkmer M, Thomas D, Schneider M (2009) Transvenous cardiac resynchronization therapy in complex congenital heart diseases: dextrocardia with transposition of the great arteries after Mustard operation. Europace 11:530–532
Alsoufi B, Awan A, Al-Omrani A, Al-Ahmadi M, Canver CC, Bulbul Z, Kalloghlian A, Al-Halees Z (2009) The Rastelli procedure for transposition of the great arteries: resection of the infundibular septum diminishes recurrent left ventricular outflow tract obstruction risk. Ann Thorac Surg 88:137–143
Chen Y, Tsai S, Chang C, Chiu I, Wang J, Wu M, Wang M (2008) Prediction of early pulmonary artery stenosis after arterial switch operation: the role of intraoperative transesophageal echocardiography. Cardiology 109:230–236
Losay J, Touchot A, Capderou A, Piot J, Belli E, Planché C, Serraf A (2006) Aortic valve regurgitation after arterial switch operation for transposition of the great arteries. J Am Coll Cardiol 47:2057–2062
Pettersen E, Fredriksen P, Urheim S, Thaulow E, Smith H, Smevik B, Smiseth O, Andersen K (2009) Ventricular function in patients with transposition of the great arteries operated with arterial switch. Am J Cardiol 104:583–589
Ploeg M, Drenthen W, van Dijk A, Pieper PG (2006) Successful pregnancy after an arterial switch procedure for complete transposition of the great arteries. BJOG 113:243–244
Oakley C, Child A, Jung B, Presbitero P, Tornos P, Klein W, Alonso Garcia MA, Blomstrom-Lundqvist C, de Backer G, Dargie H, Deckers J, Flather M, Hradec J, Mazzotta G, Oto A, Parkhomenko A, Silber S, Torbicki A, Trappe HJ, Dean V, Poumeyrol-Jumeau D (2003) Task force on the management of cardiovascular diseases during pregnancy of the European Society of Cardiology: expert consensus document on management of cardiovascular diseases during pregnancy. Eur Heart J 24:761–781
Kafka H, Johnson MR, Gatzoulis MA (2006) The team approach to pregnancy and congenital heart disease. Cardiol Clin 24:587–605
van Mook WN, Peeters L (2005) Severe cardiac disease in pregnancy, part II: impact of congenital and acquired cardiac diseases during pregnancy. Curr Opin Crit Care 11:435–448
Fernandes SM, Arendt KW, Landzberg MJ, Economy KE, Khairy P (2010) Pregnant women with congenital heart disease: cardiac, anesthetic and obstetrical implications. Expert Rev Cardiovasc Ther 8:439–448
Dharmarajan L, Hale TM, Velastegui Z, Castillo E, Kanna B (2009) Utility of two-dimensional echocardiography in pregnancy and post-partum period and impact on management in an inner city hospital. J Perinat Med 37:663–668
Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, del Nido P, Fasules JW, Graham TP Jr, Hijazi ZM, Hunt SA, King ME, Landzberg MJ, Miner PD, Radford MJ, Walsh EP, Webb GD (2008) ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation 118:e714–e833
Silversides CK, Marelli A, Beauchesne L, Dore A, Kiess M, Salehian O, Bradley T, Colman J, Connelly M, Harris L, Khairy P, Mital S, Niwa K, Oechslin E, Poirier N, Schwerzmann M, Taylor D, Vonder Muhll I, Baumgartner H, Benson L, Celermajer D, Greutmann M, Horlick E, Landzberg M, Meijboom F, Mulder B, Warnes C, Webb G, Therrien J (2010) Canadian cardiovascular society 2009 consensus conference on the management of adults with congenital heart disease: executive summary. Can J Cardiol 26:143–150
Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, Meijboom F, Mulder BJ, Oechslin E, Oliver JM, Serraf A, Szatmari A, Thaulow E, Vouhe PR, Walma E; ESC Committee for Practice Guidelines (CPG), Vahanian A, Auricchio A, Bax J, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, Document Reviewers, McDonagh T, Swan L, Andreotti F, Beghetti M, Borggrefe M, Bozio A, Brecker S, Budts W, Hess J, Hirsch R, Jondeau G, Kokkonen J, Kozelj M, Kucukoglu S, Laan M, Lionis C, Metreveli I, Moons P, Pieper PG, Pilossoff V, Popelova J, Price S, Roos-Hesselink J, Uva MS, Tornos P, Trindade PT, Ukkonen H, Walker H, Webb GD, Westby J (2010) ESC Guidelines for the management of grown-up congenital heart disease (new version 2010): the task force on the management of grown-up congenital heart disease of the European Society of Cardiology (ESC). Eur Heart J [Epub ahead of print]
Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J, American College of Chest Physicians (2008) Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edn). Chest 133(Suppl):844S–886S
Shannon MS, Edwards MB, Long F, Taylor KM, Bagger JP, De Swiet M (2008) Anticoagulant management of pregnancy following heart valve replacement in the United Kingdom, 1986–2002. J Heart Valve Dis 17:526–532
Ginsberg JS, Chan WS, Bates SM, Kaatz S (2003) Anticoagulation of pregnant women with mechanical heart valves. Arch Intern Med 163:694–698
Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, Flachskampf F, Hall R, Iung B, Kasprzak J, Nataf P, Tornos P, Torracca L, Wenink A (2007) Guidelines on the management of valvular heart disease: the task force on the management of valvular heart disease of the European society of cardiology. Eur Heart J 28:230–268
Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O’Gara PT, O’Rourke RA, Otto CM, Shah PM, Shanewise JS (2008) Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 118:e523–e661
Penning S, Robinson KD, Major CA, Garite TJ (2001) A comparison of echocardiography and pulmonary artery catheterization for evaluation of pulmonary artery pressures in pregnant patients with suspected pulmonary hypertension. Am J Obstet Gynecol 184:1568–1570
Homma A, Anzueto A, Peters JI, Susanto I, Sako E, Zabalgoitia M, Bryan CL, Levine SM (2001) Pulmonary artery systolic pressures estimated by echocardiogram vs cardiac catheterization in patients awaiting lung transplantation. J Heart Lung Transplant 20:833–839
Chemla D, Hervé P (2008) Estimation of mean pulmonary artery pressure: simpler than expected. Chest 133:592–593
Patel A, Asopa S, Tang ATM, Ohri SK (2008) Cardiac surgery during pregnancy. Tex Heart Inst J 35:307–312
Galie N, Manes A, Palazzini M, Negro L, Marinelli A, Gambetti S, Mariucci E, Donti A, Branzi A, Picchio FM (2008) Management of pulmonary arterial hypertension associated with congenital systemic-to-pulmonary shunts and Eisenmenger’s syndrome. Drugs 68:1049–1066
Bédard E, Dimopoulos K, Gatzoulis MA (2009) Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension? Eur Heart J 30:256–265
Stoddard MF, Longaker RA, Vuocolo LM, Dawkins PR (1992) Transesophageal echocardiography in the pregnant patient. Am Heart J 124:785–787
Daehnert I, Ewert P, Berger F, Lange PE (2001) Echocardiographically guided closure of a patent foramen ovale during pregnancy after recurrent strokes. J Interv Cardiol 14:191–192
Antonelli D, Bloch L, Rosenfeld T (1999) Implantation of permanent dual chamber pacemaker in a pregnant woman by transesophageal echocardiographic guidance. Pace 22:534–535
Natale A, Davidson T, Geiger MJ, Newby K (1997) Implantable cardioverter defibrillators and pregnancy. A safe combination? Circulation 96:2808–2812
Abello M, Peinado R, Merino JL, Gnoatto M, Mateos M, Silvestre J, Dominguez JL (2003) Cardioverter defibrillator implantation in a pregnant woman guided with transesophageal echocardiography. Pace 26:1913–1914
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Vitarelli, A., Capotosto, L. Role of echocardiography in the assessment and management of adult congenital heart disease in pregnancy. Int J Cardiovasc Imaging 27, 843–857 (2011). https://doi.org/10.1007/s10554-010-9750-9
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DOI: https://doi.org/10.1007/s10554-010-9750-9