Delivery in a 33-year-old woman with fontan palliation
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Fontan procedure is a surgical treatment used for patients with various forms of congenital heart disease who cannot support biventricular circulation.The single ventricle must supply cardiac output to both systemic and pulmonary circulations.Approximately 85% of the children born with a congenital heart disease are now surviving into adulthood.Despite severe heart disease, and subsequent palliation, mortality is lower than 1% with a high morbidity.During pregnancy 25% of deaths caused by cardiac complications are due to congenital heart diseases.In women with Fontan circulation, pregnancy is a challenging state because the right atrium and the single ventricle have to tolerate cardiovascular adjustments such as circulatory overload, cardiac output which is 30–40% above non-pregnant levels and heart rate.The following case report describes a parturient who underwent Fontan procedure for tricuspid atresia and pulmonic stenosis and delivered, by caesarean section at 36.5 weeks of gestation, a female infant who weighed 2400 g, without any cardiovascular complications.....

http://www.joacc.com/article.asp?issn=2249-4472;year=2017;volume=7;issue=1;spage=52;epage=53;aulast=Viappiani
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