Uncomplicated Pregnancy with Residual Tetralogy of Fallot Post-Surgery.

Büşra Özyeşil, Muhammed Fatih Kaleli, Ahmet Lütfü Sertdemir, Mehmet Akif Düzenli
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Abstract

The most common cyanotic congenital heart disease (CHD) in adults is Tetralogy of Fallot (TOF), accounting for 10% of congenital heart anomalies and 75% of cyanotic CHD cases. It is a congenital heart disease that most often requires surgical correction within the first year of life. Corrective surgical treatment for TOF began in the 20th century, starting with a temporary shunt procedure and advancing to primary surgical repair. The current approach in infants often involves valve-sparing techniques. Following corrective surgery, more than 85% of patients with TOF can survive into adulthood. Without repair, however, patients with TOF rarely reach adulthood, and the prognosis for pregnant women with CHD is poor. Congenital heart disease is one of the leading causes of indirect maternal deaths. The literature indicates that pregnant patients with corrected TOF still face a higher risk compared to otherwise healthy women. According to the modified World Health Organization maternal cardiovascular risk classification, patients with repaired TOF have a mild risk of mortality and a moderate risk of morbidity, with the risk of maternal cardiac events ranging from 5.7% to 10.5%. Cardiac evaluations should be performed at least once during each trimester of pregnancy. In this case report, we discuss the pregnancy and successful, uncomplicated birth of a woman with TOF who underwent corrective surgery in childhood.

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法洛氏四联症手术后残留的无并发症妊娠。
成人最常见的发绀型先天性心脏病(CHD)是法洛氏四联症(TOF),占先天性心脏畸形的 10%,占发绀型先天性心脏病病例的 75%。这是一种先天性心脏病,通常需要在出生后第一年内进行手术矫正。TOF 的矫正手术治疗始于 20 世纪,从临时分流术开始,发展到初级手术修复。目前对婴儿的治疗通常采用保留瓣膜的技术。接受矫正手术后,85% 以上的 TOF 患者可存活至成年。但是,如果不进行修复,TOF 患者很少能活到成年,患有先天性心脏病的孕妇预后也很差。先天性心脏病是产妇间接死亡的主要原因之一。文献表明,与其他健康女性相比,TOF 已矫正的孕妇仍面临着更高的风险。根据修改后的世界卫生组织孕产妇心血管风险分类,TOF 修复患者的死亡风险为轻度,发病风险为中度,孕产妇发生心脏事件的风险为 5.7% 至 10.5%。妊娠期的每个孕期都应至少进行一次心脏评估。在本病例报告中,我们讨论了一名在童年时接受过矫正手术的 TOF 孕妇的妊娠和顺利分娩情况。
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