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Pregnancy and the Rastelli operation.

Dorothy J Radford1, Gregory Stafford

  • 1The Prince Charles Hospital, Brisbane, Australia. dorothy_radford@health.qld.gov.au

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|May 21, 2005
PubMed
Summary

Women surviving the Rastelli repair for congenital heart disease can achieve successful pregnancies. However, subaortic stenosis may worsen during pregnancy, necessitating careful cardiac monitoring and evaluation.

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Area of Science:

  • Cardiology
  • Reproductive Medicine
  • Congenital Heart Surgery

Background:

  • The Rastelli repair is a surgical procedure for complex congenital heart lesions, enabling survival into adulthood.
  • The goal of congenital heart disease surgery is to allow patients a normal life, including pregnancy and childbirth.

Purpose of the Study:

  • To review the reproductive outcomes of women who underwent the Rastelli operation.
  • To assess the safety and success of pregnancy in adult female survivors of the Rastelli repair.

Main Methods:

  • Retrospective review of 22 female patients aged over 18 years who had the Rastelli operation between 1977 and 1999.
  • Analysis of pregnancy and childbirth outcomes, including maternal cardiac status and infant health.

Main Results:

  • Six women experienced 12 pregnancies, resulting in six live births.
  • Three women with complex transposition of the great arteries developed severe subaortic obstruction during pregnancy, requiring further surgery.
  • All infants were healthy; deliveries occurred via Cesarean section (3) or vaginally (3).

Conclusions:

  • Pregnancy is achievable for women with a history of Rastelli repair for congenital heart disease.
  • Subaortic stenosis is a significant concern that may progress during pregnancy and should be addressed pre-conception.
  • Comprehensive pre-natal, intra-partum, and post-partum cardiac evaluation is crucial for these patients.

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