Cardio-Obstetric Care in a Patient With Tricuspid Atresia and Fenestrated Fontan.

Faysal Massad, Tess Calcagno, Akiva Rosenzveig, Taha Hatab, Marko Kilsovic, Katherine Singh, Joanna Ghobrial

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Faysal MassadDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA.

Tess CalcagnoDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA.

Akiva RosenzveigDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA.

Taha HatabDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA.

Marko KilsovicDepartment of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA.

Katherine SinghCleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA; Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA.

Joanna GhobrialCleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: ghobrij@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPregnancy in patients with congenital heart disease, particularly those with Fontan physiology, presents significant risks for both the mother and fetus. CASE SUMMARY: We present a 26-year-old woman with a history of tricuspid atresia palliated with a modified fenestrated lateral tunnel Fontan, with a successful pregnancy and delivery despite numerous challenges. She was closely monitored with monthly cardio-obstetrics follow-ups, anticoagulation therapy, echocardiography, and regular obstetric ultrasounds. At 31 weeks of gestation, the patient experienced a massive placental abruption, necessitating an emergent caesarean section. Both the patient and her baby recovered well postpartum owing to meticulous predelivery planning. DISCUSSION: The Fontan procedure, which reroutes venous blood flow directly to the pulmonary arteries via passive flow, creates unique challenges during pregnancy because of altered circulatory dynamics. There is a high risk for both thrombotic and bleeding complications as well as preterm delivery, as this case represents. Specialized cardio-obstetrics monitoring with a multidisciplinary approach was essential for optimizing outcomes despite the emergent nature of her delivery. TAKE-HOME MESSAGE: Although pregnancy may be feasible with expert care, the long-term impact on Fontan function remains uncertain and potentially adverse.

Indexed as

anticoagulationcongenital heart diseaseFontan procedureheart failuremultidisciplinary carepregnancypreterm deliverythrombosis

Identifiers

PMID41288546

DOI10.1016/j.jaccas.2025.106041

PMCPMC12833648

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