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Aortopathy

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Pregnancy and Congenital Heart Disease

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

Abstract

Both hemodynamic and hormonal factors associated with normal pregnancy impose a burden on the aorta, which may have detrimental effects in case of underlying aortic fragility. Timely and correct diagnosis and recognizing the risks of pregnancy are key factors in preventing complications such as aneurysmal growth, aortic dissection or worsening aortic regurgitation. Counseling, starting well ahead of pregnancy, management and follow-up by an experienced multidisciplinary team is mandatory in women with underlying aortic disease. In this chapter we will review the most relevant diseases associated with an increased risk for aortic complications and provide recommendations for optimal care before, during and after pregnancy and delivery.

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Abbreviations

ACE:

Angiotensin converting enzyme

ART:

Assisted reproductive technologies

ASI:

Aortic size index

ASRM:

American Society for Reproductive Medicine

BAV:

Bicuspid aortic valve

BSA:

Body surface area

C-:

Caesarean

ESC:

European Society of Cardiology

FBN1:

Fibrillin 1 gene

HTAD:

Heritable thoracic aortic disorders

IRAD:

International Registry of Aortic Dissections

IUGR:

Intrauterine growth retardation

LDS:

Loeysā€“Dietz syndrome

MAC:

Montalcino Aortic Consortium

MFS:

Marfan syndrome

PGD:

Preimplantation diagnosis

PND:

Prenatal diagnosis

TAAD:

Thoracic aortic aneurysms and dissections

TAAs:

Thoracic aortic aneurysms

TAD:

Thoracic aortic dissection

TS:

Turner syndrome

vEDS:

Vascular Ehlersā€“Danlos syndrome

VSMC:

Vascular Smooth Muscle Cells

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Authors and Affiliations

  1. Department of Cardiology and Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium

    Julie De Backer MD, PhD

  2. Department of Pediatric Cardiology and Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium

    Laura MuiƱo-Mosquera MD

  3. Department of Cardiology, Ghent University Hospital, Ghent, Belgium

    Laurent Demulier MD

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  1. Julie De Backer MD, PhD
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  2. Laura MuiƱo-Mosquera MD
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  3. Laurent Demulier MD
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Correspondence to Julie De Backer MD, PhD .

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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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J. De Backer holds a grant as Senior Clinical Investigator from the Fund for Scientific Research (FWO), Flanders (Belgium). L. Muino Mosquera is supported by a doctoral fellowship from the Special Research Fund (BOF) of the University of Ghent (Belgium).

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De Backer, J., MuiƱo-Mosquera, L., Demulier, L. (2017). Aortopathy. 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_12

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