| Autor: |
Sinkey RG; Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Center for Women's Reproductive Health, Birmingham, Alabama, USA., Maxwell KS; Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA., Padilla LA; Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA., Collins IC; Heersink School of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA., Miller VM; Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA., Champion ML; Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Center for Women's Reproductive Health, Birmingham, Alabama, USA., Szychowski JM; Center for Women's Reproductive Health, Birmingham, Alabama, USA.; Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA., Mauchley D; Division of Cardiothoracic Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA., Cribbs MG; Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Alabama, USA., Wingate MS; Department of Health Policy and Organization, University of Alabama at Birmingham, Birmingham School of Public Health, Birmingham, Alabama, USA., Casey BM; Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Center for Women's Reproductive Health, Birmingham, Alabama, USA., Tita ATN; Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Center for Women's Reproductive Health, Birmingham, Alabama, USA. |
| Abstrakt: |
Background: Our objective was to investigate patient-reported maternal and perinatal outcomes and survival among women undergoing aortic valve and/or aortic root replacement (AVR/ARR). Methods: This was a single-center observational study of U.S. women identified in our surgical/obstetric databases who underwent AVR/ARR between 1967 and 2019. Available, consenting patients participated in a telephone survey detailing patient-reported outcomes. The status of remaining individuals was verified through the Alabama Department of Public Health. Date of death, immediate and underlying cause of death, and death location were abstracted from death certificates. Results: Of 317 patients, 72 were confirmed living, 86 were deceased, and 159 were of unknown status. Mean age at first aortic valve replacement was 43 years. Of patients with known status ( n = 158), 33% were Black, and the majority received a mechanical valve (58%). Of 57 participants completing the survey, reported complications included miscarriage (30%), preterm birth (12%), preeclampsia (14%), antepartum maternal intensive care unit admissions (6%), and congenital heart disease in the neonate (8%). Most pregnancies preceded AVR (78%). Among 86 decedents, the average age of death was 52.5 years; the average time from AVR/ARR to death was 7 years. Of those who died, a higher proportion were Black (75%) and had aortic insufficiency (72%). Conclusions: Patients who underwent aortic valve surgery report high rates of maternal and perinatal complications, and death certificate data confirm high rates of racial disparities and death within a decade of surgery. Interventions are urgently needed to improve maternal and perinatal outcomes in individuals with aortic valve disease and to eliminate preventable racial disparities. |
