Notice bibliographique
Résumé
One of the early repairs for complete transposition of the great arteries was the atrial-switch (Mustard or Senning) operation. This operation involved the re-direction of venous return using inter-atrial baffles. Patients with atrial-switch operations are at risk of developing a number of late complications of pregnancy, including dysfunction of the subaortic right ventricle, atrioventricular valve (AV) regurgitation, and arrhythmias. Pregnancy imposes additional haemodynamic stress on the subaortic right ventricle that can result in ventricular remodelling and deterioration in the systolic function of the ventricle. There is limited data on late effects of pregnancy on the subaortic right ventricle and the AV valve. Understanding the impact of pregnancy on maternal cardiac health is important in order for women with heart conditions to make informed pregnancy decisions. An early study examining pregnancy outcomes in this population (Guedes et al. J Am Coll Cardiol 2004;44:433–37) suggested that deterioration in subaortic ventricular function and AV valve regurgitation was common after pregnancy; however, no control group was available to determine whether this deterioration represented the natural history of the disease or the accelerated effects of pregnancy on the suboaortic right ventricle. In 2013, Bowater et al. (Congenit Heart Dis 2013;8:302–7) reported on 18 women (31 pregnancies) over a 4–5 year period and compared outcomes with 23 female and 28 male controls. In the postpartum period, pregnant women showed significant deterioration in both subaortic ventricular function and New York Heart Association (NYHA) functional status. In late follow-up, although the deterioration of subaortic ventricular function in all three groups was similar, the difference in NYHA functional status persisted in pregnant women when compared with controls. In this issue of BJOG, Cataldo et al. compare 10–year outcome data for 23 women (34 pregnancies) with atrial-switch repair with 15 female controls. In late follow-up, all women remained free of clinical heart failure and the rates of late maternal cardiac complications and deterioration of cardiac function were similar for both groups (cases versus controls). When compared with controls, however, pregnant women had a greater incidence of worsening AV valve regurgitation. In addition to adverse maternal cardiac outcomes, fetal and neonatal complications were notable, as were the high rates of labour induction for cardiac deterioration or concerns for fetal wellbeing, highlighting the impact of maternal health on fetal outcomes. Although the current study is limited by its retrospective nature, small numbers, and qualitative assessment of ventricular function, it contributes to our understanding of the late outcomes after pregnancy in this population. Although pregnancy in women with atrial-switch operations is usually well tolerated, this study and others suggest that, over the long-term, the haemodynamic stress of pregnancy may have adverse late effects on the heart, including worsening NYHA functional class and AV valve regurgitation. None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,004 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,002 | 0,000 |
| Intégrité de la recherche | 0,002 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».