JACC. Case reports · 2026
Comprehensive Cardiac Assessment and Assisted Reproductive Technology Considerations in a Long-Lost Patient With Fontan Circulation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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O'Very Sean A, Shook John E, DeZorzi Christopher J
Аннотация
BACKGROUND: Women with Fontan physiology (modified World Health Organization class III-IV) increasingly pursue pregnancy while assisted reproductive technology in this physiology adds additional hemodynamic and thrombotic risks.
CASE SUMMARY: A 29-year-old woman with tricuspid atresia palliated by a 22-mm extracardiac Fontan, lost to cardiology follow-up since age 15, was referred by her reproductive endocrinology and infertility specialist before assisted reproductive technology. Right heart catheterization, cardiac magnetic resonance, ambulatory monitoring, stress echocardiography, and laboratory testing showed a well-compensated Fontan without high-risk features. Prophylactic enoxaparin was started with ovarian stimulation and held briefly for oocyte retrieval; a comprehensive pregnancy heart team managed her care and followed her closely.
DISCUSSION: The case illustrates failed pediatric-to-adult transition, Fontan-specific preconception evaluation before assisted reproduction, and the importance of a multidisciplinary pregnancy team.
TAKE-HOME MESSAGE: Women with Fontan physiology considering pregnancy, with and without assisted reproductive technology, warrant preconception pregnancy heart team evaluation and individualized thromboprophylaxis; lapse in transition is a modifiable driver of late presentation.
CASE SUMMARY: A 29-year-old woman with tricuspid atresia palliated by a 22-mm extracardiac Fontan, lost to cardiology follow-up since age 15, was referred by her reproductive endocrinology and infertility specialist before assisted reproductive technology. Right heart catheterization, cardiac magnetic resonance, ambulatory monitoring, stress echocardiography, and laboratory testing showed a well-compensated Fontan without high-risk features. Prophylactic enoxaparin was started with ovarian stimulation and held briefly for oocyte retrieval; a comprehensive pregnancy heart team managed her care and followed her closely.
DISCUSSION: The case illustrates failed pediatric-to-adult transition, Fontan-specific preconception evaluation before assisted reproduction, and the importance of a multidisciplinary pregnancy team.
TAKE-HOME MESSAGE: Women with Fontan physiology considering pregnancy, with and without assisted reproductive technology, warrant preconception pregnancy heart team evaluation and individualized thromboprophylaxis; lapse in transition is a modifiable driver of late presentation.