Dr. Kevin Walsh:

Senator Crown asked a question about the quantification of risk. We have some scores for major adverse cardiac events but they usually include death along with other complications. Generally, we consider a condition where the risk of death is 5% to 10% as being very significant. Mothers will take any chance to have a baby but a 5% to 10% risk is really significant. In the Eisenmenger patient the risk is up at 30% to 50%. That would be a case where if there was earlier identification we would certainly want to recommend an early termination. It is different. We have had Eisenmenger patients come to term or close to term. Equally, Eisenmenger patients have died in this city during pregnancy. That is the sort of level of risk.