Pregnancy outcomes in women with a systemic right ventricle and transposition of the
great arteries results from the ESC-EORP Registry of Pregnancy and Cardiac disease
(ROPAC)
Tutarel, Oktay; Baris, Lucia*; Budts, Werner; Gamal Abd-El Aziz, Mohamad; Liptai, Csilla [Liptai, Margit Csilla (belgyógyászat, ka...), author] Department of
Cardiology – Heart and Vascular C... (SU / FM / C); Majdalany, David; Jovanova, Silvana; Frogoudaki, Alexandra; Connolly, Heidi M; Johnson, Mark R; Maggioni, Aldo P; Hall, Roger; Roos-Hesselink, Jolien W ✉; Gale, Christopher Peter [Collaborator]; ROPAC Investigators Group [Collaborative Organization]; Beleslin, Branko [Collaborator]; Budaj, Andrzej [Collaborator]; Chioncel, Ovidiu [Collaborator]; Dagres, Nikolaos [Collaborator]; Danchin, Nicolas [Collaborator]; Erlinge, David [Collaborator]; Emberson, Jonathan [Collaborator]; Glikson, Michael [Collaborator]; Gray, Alastair [Collaborator]; Kayikcioglu, Meral [Collaborator]; Maggioni, Aldo [Collaborator]; Nagy, Klaudia Vivien [Nagy, Klaudia Vivien (orvostudományok), Collaborator] Department
of Cardiology – Heart and Vascular C... (SU / FM / C); Nedoshivin, Aleksandr [Collaborator]; Petronio, Anna-Sonia [Collaborator]; Roos-Hesselink, Jolien [Collaborator]; Wallentin, Lars [Collaborator]; Zeymer, Uwe [Collaborator]; Hall, Roger [Collaborator]; Roos-Hesselink, Jolien [Collaborator]; Stein, Joerg [Collaborator]; Parsonage, William Anthony [Collaborator]; Budts, Werner [Collaborator]; Backer, Julie De [Collaborator]; Grewal, Jasmin [Collaborator]; Kaemmerer, Harald [Collaborator]; Marelli, Ariane [Collaborator]; Jondeau, Guillaume [Collaborator]; Johnson, Mark [Collaborator]; Maggioni, Aldo P [Collaborator]; Tavazzi, Luigi [Collaborator]; Thilen, Ulf [Collaborator]; Elkayam, Uri [Collaborator]; Otto, Catherine [Collaborator]; Sliwa, Karen [Collaborator]; Aquieri, A [Collaborator]; Saad, A [Collaborator]; Ruda Vega, H [Collaborator]; Hojman, J [Collaborator]; Caparros, J M [Collaborator]; Vazquez Blanco, M [Collaborator]; Arstall, M [Collaborator]; Chung, C M [Collaborator]; Mahadavan, G [Collaborator]; Aldridge, E [Collaborator]; Wittwer, M [Collaborator]; Chow, Y Y [Collaborator]; Parsonage, W A [Collaborator]; Lust, K [Collaborator]; Collins, N [Collaborator]; Warner, G [Collaborator]; Hatton, R [Collaborator]; Gordon, A [Collaborator]; Nyman, E [Collaborator]; Stein, J [Collaborator]; Donhauser, E [Collaborator]; Gabriel, H [Collaborator]; Bahshaliyev, A [Collaborator]; Guliyev, F [Collaborator]; Hasanova, I [Collaborator]; Jahangirov, T [Collaborator]; Gasimov, Z [Collaborator]; Salim, A [Collaborator]; Ahmed, C M [Collaborator]; Begum, F [Collaborator]; Hoque, M H [Collaborator]; Mahmood, M [Collaborator]; Islam, M N [Collaborator]; Haque, P P [Collaborator]; Banerjee, S K [Collaborator]; Parveen, T [Collaborator]; Morissens, M [Collaborator]; De Backer, J [Collaborator]; Demulier, L [Collaborator]; de Hosson, M [Collaborator]; Budts, W [Collaborator]; Beckx, M [Collaborator]; Kozic, M [Collaborator]; Lovric, M [Collaborator]; Kovacevic-Preradovic, T [Collaborator]; Chilingirova, N [Collaborator]; Kratunkov, P [Collaborator]; McLean, S [Collaborator]; Gordon, E [Collaborator]; Walter, L [Collaborator]; Marelli, A [Collaborator]; Montesclaros, A R [Collaborator]; Monsalve, G [Collaborator]; Rodriguez, C [Collaborator]; Balthazar, F [Collaborator]; Quintero, V [Collaborator]; Palacio, W [Collaborator]; Mejía Cadavid, L A [Collaborator]; Munoz Ortiz, E [Collaborator]; Fortich Hoyos, F [Collaborator]; Arevalo Guerrero, E [Collaborator]; Gandara Ricardo, J [Collaborator]; Velasquez Penagos, J [Collaborator]; Vavera, Z [Collaborator]; Popelova, J [Collaborator]; Vejlstrup, N [Collaborator]; Grønbeck, L [Collaborator]; Johansen, M [Collaborator]; Ersboll, A [Collaborator]; Elrakshy, Y [Collaborator]; Eltamawy, K [Collaborator]; Gamal Abd-El Aziz, M [Collaborator]; El Nagar, A [Collaborator]; Ebaid, H [Collaborator]; Abo Elenin, H [Collaborator]; Saed, M [Collaborator]; Farag, S [Collaborator]; Makled, W [Collaborator]; Sorour, K [Collaborator]; Ashour, Z [Collaborator]; El-Sayed, G [Collaborator]; Abdel Meguid Mahdy, M [Collaborator]; Taha, N [Collaborator]; Dardeer, A [Collaborator]; Shabaan, M [Collaborator]; Saad, A [Collaborator]; Ali, M [Collaborator]; Moceri, P [Collaborator]; Duthoit, G [Collaborator]; Gouton, M [Collaborator]; Nizard, J [Collaborator]; Baris, L [Collaborator]; Cohen, S [Collaborator]; Ladouceur, M [Collaborator]; Khimoud, D [Collaborator]; Iung, B [Collaborator]; Berger, F [Collaborator]; Olsson, A [Collaborator]; Gembruch, U [Collaborator]; Merz, W M [Collaborator]; Reinert, E [Collaborator]; Clade, S [Collaborator]; Kliesch, Y [Collaborator]; Wald, C [Collaborator]; Sinning, C [Collaborator]; Kozlik-Feldmann, R [Collaborator]; Blankenberg, S [Collaborator]; Zengin-Sahm, E [Collaborator]; Mueller, G [Collaborator]; Hillebrand, M [Collaborator]; Hauck, P [Collaborator]; von Kodolitsch, Y [Collaborator]; Zarniko, N [Collaborator]; Baumgartner, H [Collaborator]; Hellige, A [Collaborator]; Tutarel, O [Collaborator]; Kaemmerer, H [Collaborator]; Kuschel, B [Collaborator]; Nagdyman, N [Collaborator]; Motz, R [Collaborator]; Maisuradze, D [Collaborator]; Frogoudaki, A [Collaborator]; Iliodromitis, E [Collaborator]; Anastasiou-Nana, M [Collaborator]; Marousi, D [Collaborator]; Triantafyllis, G [Collaborator]; Bekiaris, H Karvounis [Collaborator]; Giannakoulas, G [Collaborator]; Ntiloudi, D [Collaborator]; Mouratoglou, S A [Collaborator]; Temesvari, A [Temesvári, András (Kardiológia), Collaborator]; Balint, H [Collaborator]; Kohalmi, D [Kőhalmi, Dóra (Kardiológia), Collaborator]; Merkely, B [Merkely, Béla Péter (Kardiológia), Collaborator] Cardiovascular Center
(SU / FM / C); Department of Cardiology – Heart and Vascular C... (SU / FM / C); Faculty
of Sports Medicine (SU / FM / C); Liptai, C [Liptai, Margit Csilla (belgyógyászat, ka...), Collaborator] Department
of Cardiology – Heart and Vascular C... (SU / FM / C); Nemes, A [Nemes, Attila (kardiológia, echo...), Collaborator] First Department of
Internal Medicine (SZTE / ASZMS / DIMedicine); Forster, T [Forster, Tamás (Kardiológia), Collaborator] Second Department of Internal
Medicine and Card... (SZTE / ASZMS / DIMedicine); Kalapos, A [Kalapos, Anita (kardiológia), Collaborator] Second Department of Internal
Medicine and Card... (SZTE / ASZMS / DIMedicine); Berek, K [Collaborator]; Havasi, K [Havasi, Kálmán (belgyógyászat/kar...), Collaborator] Second Department
of Internal Medicine and Card... (SZTE / ASZMS / DIMedicine); Ambrus, N [Ambrus, Nóra (kardiológia), Collaborator] Second Department of Internal
Medicine and Card... (SZTE / ASZMS / DIMedicine); Shelke, A [Collaborator]; Kawade, R [Collaborator]; Patil, S [Collaborator]; Martanto, E [Collaborator]; Aprami, T M [Collaborator]; Purnomowati, A [Collaborator]; Cool, C J [Collaborator]; Hasan, M [Collaborator]; Akbar, R [Collaborator]; Hidayat, S [Collaborator]; Dewi, T I [Collaborator]; Permadi, W [Collaborator]; Soedarsono, D A [Collaborator]; Ansari-Ramandi, M M [Collaborator]; Samiei, N [Collaborator]; Tabib, A [Collaborator]; Kashfi, F [Collaborator]; Ansari-Ramandi, S [Collaborator]; Rezaei, S [Collaborator]; Ali Farhan, H [Collaborator]; Al-Hussein, A [Collaborator]; Al-Saedi, G [Collaborator]; Mahmood, G [Collaborator]; Yaseen, I F [Collaborator]; Al-Yousuf, L [Collaborator]; AlBayati, M [Collaborator]; Mahmood, S [Collaborator]; Raheem, S [Collaborator]; AlHaidari, T [Collaborator]; Dakhil, Z [Collaborator]; Thornton, P [Collaborator]; Donnelly, J [Collaborator]; Bowen, M [Collaborator]; Blatt, A [Collaborator]; Elbaz-Greener, G [Collaborator]; Shotan, A [Collaborator]; Yalonetsky, S [Collaborator]; Goland, S [Collaborator]; Biener, M [Collaborator]; Egidy Assenza, G [Collaborator]; Bonvicini, M [Collaborator]; Donti, A [Collaborator]; Bulgarelli, A [Collaborator]; Prandstraller, D [Collaborator]; Romeo, C [Collaborator]; Crepaz, R [Collaborator]; Sciatti, E [Collaborator]; Metra, M [Collaborator]; Orabona, R [Collaborator]; Ait Ali, L [Collaborator]; Festa, P [Collaborator]; Fesslova, V [Collaborator]; Bonanomi, C [Collaborator]; Calcagnino, M [Collaborator]; Lombardi, F [Collaborator]; Colli, A M [Collaborator]; Ossola, M W [Collaborator]; Gobbi, C [Collaborator]; Gherbesi, E [Collaborator]; Tondi, L [Collaborator]; Schiavone, M [Collaborator]; Squillace, M [Collaborator]; Carmina, M G [Collaborator]; Maina, A [Collaborator]; Macchi, C [Collaborator]; Gollo, E [Collaborator]; Comoglio, F M [Collaborator]; Montali, N [Collaborator]; Re, P [Collaborator]; Bordese, R [Collaborator]; Todros, T [Collaborator]; Donvito, V [Collaborator]; Grosso Marra, W [Collaborator]; Sinagra, G [Collaborator]; D'Agata Mottolese, B [Collaborator]; Bobbo, M [Collaborator]; Gesuete, V [Collaborator]; Rakar, S [Collaborator]; Ramani, F [Collaborator]; Niwa, K [Collaborator]; Mekebekova, D [Collaborator]; Mussagaliyeva, A [Collaborator]; Lee, T [Collaborator]; Mirrakhimov, E [Collaborator]; Abilova, S [Collaborator]; Bektasheva, E [Collaborator]; Neronova, K [Collaborator]; Lunegova, O [Collaborator]; Žaliūnas, R [Collaborator]; Jonkaitienė, R [Collaborator]; Petrauskaitė, J [Collaborator]; Laucevicius, A [Collaborator]; Jancauskaite, D [Collaborator]; Lauciuviene, L [Collaborator]; Gumbiene, L [Collaborator]; Lankutiene, L [Collaborator]; Glaveckaite, S [Collaborator]; Laukyte, M [Collaborator]; Solovjova, S [Collaborator]; Rudiene, V [Collaborator]; Chee, K H [Collaborator]; C C-W, Yim [Collaborator]; Ang, H L [Collaborator]; Kuppusamy, R [Collaborator]; Watson, T [Collaborator]; Caruana, M [Collaborator]; Estensen, M-E [Collaborator]; Mahmood Kayani, M G A [Collaborator]; Munir, R [Collaborator]; Tomaszuk-Kazberuk, A [Collaborator]; Sobkowicz, B [Collaborator]; Przepiesc, J [Collaborator]; Lesniak-Sobelga, A [Collaborator]; Tomkiewicz-Pajak, L [Collaborator]; Komar, M [Collaborator]; Olszowska, M [Collaborator]; Podolec, P [Collaborator]; Wisniowska-Smialek, S [Collaborator]; Lelonek, M [Collaborator]; Faflik, U [Collaborator]; CichockaRadwan, A [Collaborator]; Plaskota, K [Collaborator]; Trojnarska, O [Collaborator]; Guerra, N [Collaborator]; de Sousa, L [Collaborator]; Cruz, C [Collaborator]; Ribeiro, V [Collaborator]; Jovanova, S [Collaborator]; Petrescu, V [Collaborator]; Jurcut, R [Collaborator]; Ginghina, C [Collaborator]; Mircea Coman, I [Collaborator]; Musteata, M [Collaborator]; Osipova, O [Collaborator]; Golivets, T [Collaborator]; Khamnagadaev, I [Collaborator]; Golovchenko, O [Collaborator]; Nagibina, A [Collaborator]; Ropatko, I [Collaborator]; Gaisin, I R [Collaborator]; Valeryevna Shilina, L [Collaborator]; Sharashkina, N [Collaborator]; Shlyakhto, E [Collaborator]; Irtyuga, O [Collaborator]; Moiseeva, O [Collaborator]; Karelkina, E [Collaborator]; Zazerskaya, I [Collaborator]; Kozlenok, A [Collaborator]; Sukhova, I [Collaborator]; Jovovic, L [Collaborator]; Prokšelj, K [Collaborator]; Koželj, M [Collaborator]; Askar, A O [Collaborator]; Abdilaahi, A A [Collaborator]; Mohamed, M H [Collaborator]; Dirir, A M [Collaborator]; Sliwa, K [Collaborator]; Manga, P [Collaborator]; Pijuan-Domenech, A [Collaborator]; Galian-Gay, L [Collaborator]; Tornos, P [Collaborator]; Subirana, M T [Collaborator]; Subirana, M T [Collaborator]; Murga, N [Collaborator]; Oliver, J M [Collaborator]; Garcia-Aranda Dominguez, B [Collaborator]; Hernandez Gonzalez, I [Collaborator]; Delgado Jimenez, J F [Collaborator]; Escribano Subias, P [Collaborator]; Elbushi, A [Collaborator]; Suliman, A [Collaborator]; Jazzar, K [Collaborator]; Murtada, M [Collaborator]; Ahamed, N [Collaborator]; Dellborg, M [Collaborator]; Furenas, E [Collaborator]; Jinesjo, M [Collaborator]; Skoglund, K [Collaborator]; Eriksson, P [Collaborator]; Gilljam, T [Collaborator]; Thilen, U [Collaborator]; Tobler, D [Collaborator]; Wustmann, K [Collaborator]; Schwitz, F [Collaborator]; Rutz, T [Collaborator]; Bouchardy, J [Collaborator]; Greutmann, M [Collaborator]; Santos Lopes, B M [Collaborator]; Meier, L [Collaborator]; Arrigo, M [Collaborator]; de Boer, K [Collaborator]; Konings, T [Collaborator]; Wagenaar, L J [Collaborator]; Polak, P [Collaborator]; Pieper, E Pg [Collaborator]; RoosHesselink, J [Collaborator]; Baris, L [Collaborator]; van Hagen, I [Collaborator]; Duvekot, H [Collaborator]; Cornette, J M J [Collaborator]; De Groot, C [Collaborator]; van Oppen, C [Collaborator]; Sarac, L [Collaborator]; Batukan Esen, O [Collaborator]; Catirli Enar, S [Collaborator]; Mondo, C [Collaborator]; Ingabire, P [Collaborator]; Nalwanga, B [Collaborator]; Semu, T [Collaborator]; Salih, B T [Collaborator]; Almahmeed, W A R [Collaborator]; Wani, S [Collaborator]; Mohamed Farook, F S [Collaborator]; Al Ain, F [Collaborator]; Gerges, A M [Collaborator]; Komaranchath, F [Collaborator]; Al Bakshi, A [Collaborator]; Al Mulla, A H [Collaborator]; Yusufali, E I [Collaborator]; Al Hatou, N [Collaborator]; Bazargani, F [Collaborator]; Hussain, L [Collaborator]; Hudsmith, P [Collaborator]; Thompson, S [Collaborator]; Thorne, S [Collaborator]; Bowater, A [Collaborator]; Money-Kyrle, P [Collaborator]; Clifford, P [Collaborator]; Ramrakha, S Firoozan [Collaborator]; Chaplin, J [Collaborator]; Bowers, N [Collaborator]; Adamson, D [Collaborator]; Schroeder, F [Collaborator]; Wendler, R [Collaborator]; Hammond, S [Collaborator]; Nihoyannopoulos, P [Collaborator]; Hall, R [Collaborator]; Freeman, L [Collaborator]; Kerr, J [Collaborator]; Tellett, L [Collaborator]; Scott, N [Collaborator]; Bhatt, A B [Collaborator]; DeFaria Yeh, D [Collaborator]; Youniss, M A [Collaborator]; Wood, M [Collaborator]; Sarma, A A [Collaborator]; Tsiaras, S [Collaborator]; Stefanescu, A [Collaborator]; Duran, J M [Collaborator]; Stone, L [Collaborator]; Majdalany, D S [Collaborator]; Chapa, J [Collaborator]; Chintala, K [Collaborator]; Gupta, P [Collaborator]; Botti, J [Collaborator]; Ting, J [Collaborator]; Davidson, W R [Collaborator]; Wells, G [Collaborator]; Sparks, D [Collaborator]; Paruchuri, V [Collaborator]; Marzo, K [Collaborator]; Patel, D [Collaborator]; Wagner, W [Collaborator]; Ahanya, S N [Collaborator]; Colicchia, L [Collaborator]; Jentink, T [Collaborator]; Han, K [Collaborator]; Loichinger, M [Collaborator]; Parker, M [Collaborator]; Wagner, W [Collaborator]; Longtin, C [Collaborator]; Yetman, A [Collaborator]; Erickson, K [Collaborator]; Cramer, J [Collaborator]; Tsai, S [Collaborator]; Fletcher, B [Collaborator]; Warta, S [Collaborator]; Cohen, C [Collaborator]; Lindblade, C [Collaborator]; Puntel, R [Collaborator]; Nagaran, K [Collaborator]; Croft, N [Collaborator]; Gurvitz, M [Collaborator]; Otto, C [Collaborator]; Talluto, C [Collaborator]; Murphy, D [Collaborator]; Perlroth, M G [Collaborator]
Cardiac disease is a major cause of maternal mortality. Data regarding pregnancy outcomes
in women with a systemic right ventricle (sRV) are scarce. We studied pregnancy outcomes
in women with an sRV after the atrial switch procedure for transposition of the great
arteries (TGA) or congenitally corrected TGA (CCTGA).The ESC EORP Registry of Pregnancy
and Cardiac Disease is an international prospective registry of pregnant women with
cardiac disease. Pregnancy outcomes (maternal/fetal) in all women with an sRV are
described. The primary end point was a major adverse cardiac event (MACE) defined
as maternal death, supraventricular or ventricular arrhythmias requiring treatment,
heart failure, aortic dissection, endocarditis, ischaemic coronary event and other
thromboembolic events.Altogether, 162 women with an sRV (TGA n=121, CCTGA n=41, mean
age 28.8±4.6 years) were included. No maternal mortality occurred. In 26 women, at
least one MACE occurred, heart failure in 16 (9.8%), arrhythmias (atrial 5, ventricular
6) in 11 (6.7%) and others in 4 (2.5%). Prepregnancy signs of heart failure as well
as an sRV ejection fraction <40% were predictors of MACE. One woman experienced fetal
loss, while no neonatal mortality was observed. No significant differences were found
between women with CCTGA and TGA. In the subset of women who had an echocardiogram
before and after pregnancy, no clear deterioration in sRV was observed.The majority
of women with an sRV tolerated pregnancy well with a favourable maternal and fetal
outcome. Heart failure and arrhythmias were the most common MACE.