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Assisted Reproductive Technology Outcomes in Women With Heart Disease

Quien, Mary M; Hausvater, Anaïs; Maxwell, Susan M; Weinberg, Catherine R
Background/UNASSIGNED:Women with infertility and heart disease (HD) are increasingly seeking assisted reproductive technology (ART). There is only one other study that examines the safety profile of ART in this population. This study aims to evaluate the cardiac, reproductive, and obstetric outcomes of ART in women with HD. Methods/UNASSIGNED:fertilization (IVF), oocyte cryopreservation (OC) or embryo banking (EB) with HD were included. Cases were matched 3:1 with age-, cycle type- and cycle start date- matched controls without HD. Outcomes included cardiovascular (CV), reproductive, and obstetric complications during or following ART. Results/UNASSIGNED:Twenty women with HD were included. 15 (75%) had congenital HD, 1 (5%) had valvular disease, 1 (5%) had acquired cardiomyopathy, and 3 (15%) had arrhythmias. 90% were New York Heart Association class I. 55% of HD cases were modified WHO (mWHO) risk classification 1-2, 40% were mWHO 2-3 or 3, 5% were mWHO 4. Cases underwent 25 IVF, 5 OC, and 5 EB cycles and were compared with 79 controls who underwent 174 cycles. No CV complications or deaths occurred amongst cases following ART or pregnancy. There was no difference in risk of ART or obstetric outcomes amongst cases versus controls. Conclusion/UNASSIGNED:For women with HD in this small, low -risk cohort, ART posed few risks that were similar in frequency to healthy controls.
PMCID:9035694
PMID: 35479266
ISSN: 2297-055x
CID: 5217532

Sex-Based Differences in COVID-19 Outcomes

Tejpal, Astha; Gianos, Eugenia; Cerise, Jane; Hirsch, Jamie S; Rosen, Stacey; Kohn, Nina; Lesser, Martin; Weinberg, Catherine; Majure, David; Satapathy, Sanjaya K; Bernstein, David; Barish, Matthew A; Spyropoulos, Alex C; Brown, Rachel-Maria
PMID: 33885345
ISSN: 1931-843x
CID: 4847302

Pregnancy in women with congenital heart disease: A guide for the general cardiologist

Weinberg, Catherine R.; Ahmad, Amier; Li, Boyangzi; Halpern, Dan G.
Remarkable advances in the care and survival of congenital heart disease (CHD) patients have led to increasing numbers of young women with CHD who carry a pregnancy with significant risk. The profound hemodynamic changes that naturally occur during gestation may unmask CHD or exacerbate an existing condition and place both the woman and fetus in jeopardy. The caring cardiologist should be familiar with the specific lesion and anticipate complications. Pregestational counseling and a multidisciplinary team approach during pregnancy are key for a successful pregnancy and favorable outcomes. In this review we discuss the evaluation of the expecting CHD patient and focus on the commonly encountered lesions.
SCOPUS:85112805598
ISSN: 1758-3896
CID: 5002932

ASSISTED REPRODUCTIVE TECHNOLOGY IN WOMEN WITH HEART DISEASE [Meeting Abstract]

Hausvater, Anais; Quien, Mary; Maxwell, Susan M.; Weinberg, Catherine R.
ISI:000522979100629
ISSN: 0735-1097
CID: 5285672

Use of Medication for Cardiovascular Disease During Pregnancy: JACC State-of-the-Art Review

Halpern, Dan G; Weinberg, Catherine R; Pinnelas, Rebecca; Mehta-Lee, Shilpi; Economy, Katherine E; Valente, Anne Marie
Cardiovascular disease complicating pregnancy is rising in prevalence secondary to advanced maternal age, cardiovascular risk factors, and the successful management of congenital heart disease conditions. The physiological changes of pregnancy may alter drug properties affecting both mother and fetus. Familiarity with both physiological and pharmacological attributes is key for the successful management of pregnant women with cardiac disease. This review summarizes the published data, available guidelines, and recommendations for use of cardiovascular medications during pregnancy. Care of the pregnant woman with cardiovascular disease requires a multidisciplinary team approach with members from cardiology, maternal fetal medicine, anesthesia, and nursing.
PMID: 30704579
ISSN: 1558-3597
CID: 3626882

Acute Myocardial Infarction During Pregnancy and the Puerperium in the United States

Smilowitz, Nathaniel R; Gupta, Navdeep; Guo, Yu; Zhong, Judy; Weinberg, Catherine R; Reynolds, Harmony R; Bangalore, Sripal
OBJECTIVE:To analyze trends in the incidence, in-hospital management, and outcomes of acute myocardial infarction (AMI) complicating pregnancy and the puerperium in the United States. PATIENTS AND METHODS/METHODS:Women 18 years or older hospitalized during pregnancy and the puerperium were identified from the National Inpatient Sample database from January 1, 2002, to December 31, 2014. International Classification of Diseases, Ninth Revision diagnosis and procedure codes were used to identify AMI during pregnancy-related admissions. RESULTS:Overall, 55,402,290 pregnancy-related hospitalizations were identified. A total of 4471 cases of AMI (8.1 [95% CI, 7.5-8.6] cases per 100,000 hospitalizations) occurred, with 922 AMI cases (20.6%) identified in the antepartum period, 1061 (23.7%) during labor and delivery, and 2390 (53.5%) in the postpartum period. ST-segment elevation myocardial infarction occurred in 1895 cases (42.4%), and non-ST-segment elevation myocardial infarction occurred in 2576 cases (57.6%). Among patients with pregnancy-related AMI, 2373 (53.1%) underwent invasive management and 1120 (25.1%) underwent coronary revascularization. In-hospital mortality was significantly higher in patients with AMI than in those without AMI during pregnancy (adjusted odds ratio, 39.9; 95% CI, 23.3-68.4; P<.001). The rate of AMI during pregnancy and the puerperium increased over time (adjusted odds ratio, 1.25 [for 2014 vs 2002]; 95% CI, 1.02-1.52). CONCLUSION/CONCLUSIONS:In patients hospitalized during pregnancy and the puerperium, AMI occurred in 1 of every 12,400 hospitalizations and rates of AMI increased over time. Maternal mortality rates were high. Additional research on the prevention and optimal management of AMI during pregnancy is necessary.
PMID: 30031555
ISSN: 1942-5546
CID: 3216252

ACUTE MYOCARDIAL INFARCTION DURING PREGNANCY AND THE PUERPERIUM IN THE UNITED STATES [Meeting Abstract]

Smilowitz, Nathaniel Rosso; Gupta, Navdeep; Guo, Yu; Weinberg, Catherine; Reynolds, Harmony; Bangalore, Sripal
ISI:000429659700006
ISSN: 0735-1097
CID: 3055362

Intimal spindle cell sarcoma masquerading as adult-onset symptomatic pulmonic stenosis: a case report and review of the literature

Manmadhan, Arun; Malhotra, Sunil P; Weinberg, Catherine R; Reyentovich, Alex; Latson, Larry A Jr; Bhatla, Puneet; Saric, Muhamed
BACKGROUND: Pulmonary artery intimal spindle cell sarcomas are rare and carry with them a poor prognosis and high rate of recurrence. In extremely rare cases, this tumor can infiltrate the pulmonic valve and manifest as adult-onset pulmonic stenosis. CASE PRESENTATION: We report an unusual case of a patient with symptomatic, adult-onset severe pulmonic stenosis who was referred for possible balloon valvuloplasty but was subsequently found to have pulmonary artery intimal sarcoma infiltrating the pulmonary valve leading to progressive exertional dyspnea. CONCLUSION: The presence of adult-onset pulmonic stenosis should prompt the clinician to investigate further as most cases of pulmonic stenosis are congenital in nature and present early in life. Careful diagnostic evaluation in concert with multimodal imaging should take place to arrive at the correct and challenging diagnosis of sarcoma-induced adult-onset severe pulmonic stenosis. Given the poor prognosis and rapid progression of disease, early diagnosis is crucial.
PMCID:5663046
PMID: 29084562
ISSN: 1749-8090
CID: 2765092

The Tale of Two Chambers : Late Diagnosis of a Young Condition [Meeting Abstract]

Dwivedi, Aeshita; Weinberg, Catherine; Jung, Albert
ISI:000396815605120
ISSN: 0009-7322
CID: 3130092

Pulmonary valve replacement in tetralogy of fallot

Weinberg, Catherine R; McElhinney, Doff B
PMID: 25156915
ISSN: 0009-7322
CID: 1161632