Valve Thrombosis In Pregnancy Research Articles

British Society for Haematology guideline for anticoagulantmanagement of pregnant individuals with mechanical heart valves.

British Society for Haematology guideline for anticoagulantmanagement of pregnant individuals with mechanical heart valves.

Challenges of managing patients with mechanical heart valve thrombosis in pregnancy: A case series

Mechanical valve thrombosis is a feared complication in pregnant women with mechanical heart valves (MHV). It is associated with a high maternal and foetal morbidity and mortality. Optimal anticoagulation strategies for pregnant women with MHV remain controversial. Vitamin K antagonists (VKA) are the most effective treatment regimen to prevent valve thrombosis and are therefore considered the safest treatment for the mother. However, VKAs increase the risk of embryopathy, foetopathy, foetal haemorrhage and foetal loss. A particular challenge is to balance the need for adequate anticoagulation for MHV during pregnancy against the risk of bleeding, teratogenicity and fetotoxicity. In this case series, we describe complexity of the management of anticoagulation in pregnant patients with MHV, and describe 2 treatment approaches in patients with MHV thrombosis. Our case series high-lights that anticoagulation strategy should be individualised, and that best management is provided by a multidisciplinary cardio-obstetric team.

A case report: mechanical tricuspid valve thrombosis necessitating cardiac surgery during pregnancy.

BackgroundPregnant women with mechanical valves are considered a high-risk pregnancy. They carry an increased risk of both maternal and foetal complications. This includes maternal valve thrombosis, foetal embryopathy, and haemorrhage. Cardiac surgery is generally avoided during pregnancy, and is used when there are no other alternative options. Cardiopulmonary bypass (CPB) during pregnancy is associated with high foetal mortality. Maternal mortality in the setting of CPB however, is not dissimilar to a non-pregnant woman.Case summaryWe present the case of a 29-year-old woman with Ebstein’s anomaly who developed thrombosis of her mechanical tricuspid valve at 4 weeks’ gestation. This was suspected to be likely due to sub-therapeutic anticoagulation at the time of presentation. She underwent a tricuspid valve replacement during the first trimester of pregnancy after failing medical therapy, with overall favourable maternal and foetal outcomes.DiscussionValve thrombosis during pregnancy is a devastating complication. There is limited data surrounding the best management strategy of valve thrombosis in pregnancy. Cardiac surgery with CPB is reserved for cases refractory to appropriate medical therapy. Though maternal mortality is largely unaffected, foetal mortality with CPB remains high. The management of pregnant women undergoing CPB is unique and extremely challenging. It requires a meticulous, multidisciplinary approach to improve overall outcomes.

Prosthetic mechanic valve thrombosis in pregnancy: a single center study of 7 cases

Background: Pregnancy in women with mechanical prosthetic heart valves carried an increased risk of thromboembolic complications due to changes in haemostasis. Prosthetic valve thrombosis is a serious complication resulting in high mortality. We reviewed the incidence, risk factors, and treatment strategies of this rare complication. Methods: In the present study 86 pregnancies in 57 women with prosthetic mechanical heart valve replacement were identified in our institution between 1985 and 2011. After careful review of the records, the most likely preditors of prosthetic valve thrombosis was assigned. Results: Seven patients from 23 to 38 years of age (mean age was 30 years) had 7 thromboses of mechanical heart prostheses during pregnancy. The prosthesis was mitral in all cases. The prosthesis was a ball valve in 3 cases and bi-leaflet in 4 cases. The most frequent clinical presentation was severe congestive heart failure. Initial emergency treatment was surgical in 3 cases and medical in 4 cases (simple heparin therapy). Secondary surgery was carried out in one patient after failure of heparin therapy. There was one death in the surgical group and 33% foetal mortality in the surviving women. In univariate analysis, predictors of prosthetic valve thrombosis were: inadequate level of anticoagulation and dilation of the left atrium Conclusion: Thrombosis is the most life-threatening complication for women with prosthetic heart valve during pregnancy. Inadequate level of anticoagulation and dilation of the left atrium are the two factors involved in the pathogenesis of prosthetic valve thrombosis. The overall mortality rate despite surgical treatment remains high. This study underscores the importance of meticulous surveillance of anticoagulation therapy in pregnant women with prosthetic valves.

Circulation : Clinical Summaries

<i>Circulation</i> : Clinical Summaries

Treatment of Obstructive Prosthetic Heart Valve Thrombosis in Pregnancy

Journal of Cardiac SurgeryVolume 25, Issue 2 p. 206-206 Treatment of Obstructive Prosthetic Heart Valve Thrombosis in Pregnancy Murat Biteker M.D., Murat Biteker M.D. Kosuyolu Heart and Research Hospital, Cardiology Department, Istanbul, TurkeySearch for more papers by this authorMehmet Özkan M.D., Mehmet Özkan M.D. Kosuyolu Heart and Research Hospital, Cardiology Department, Istanbul, TurkeySearch for more papers by this author Murat Biteker M.D., Murat Biteker M.D. Kosuyolu Heart and Research Hospital, Cardiology Department, Istanbul, TurkeySearch for more papers by this authorMehmet Özkan M.D., Mehmet Özkan M.D. Kosuyolu Heart and Research Hospital, Cardiology Department, Istanbul, TurkeySearch for more papers by this author First published: 02 March 2010 https://doi.org/10.1111/j.1540-8191.2009.00822.xCitations: 5 Address for correspondence: Murat Biteker, M.D., Cardiology Resident, Kosuyolu Heart and Research Hospital, Cardiology Department, Kosuyolu Heart and Research Hospital, Cevizli/Kartal/Istanbul, Turkey. Fax: +902164596321; e-mail: [email protected] The authors have no financial or any other kind of personal conflicts with this letter. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume25, Issue2March 2010Pages 206-206 RelatedInformation

P62 Thrombophilia and prosthetic valve thrombosis in pregnancy

P62 Thrombophilia and prosthetic valve thrombosis in pregnancy

Prosthetic pulmonary valve thrombosis in pregnancy successfully treated with thrombolysis

Prosthetic pulmonary valve thrombosis in pregnancy successfully treated with thrombolysis

5 Thrombophilia and prosthetic valve thrombosis in pregnancy – study of 7 cases

5 Thrombophilia and prosthetic valve thrombosis in pregnancy – study of 7 cases

Thrombolytic therapy and combined cesarean section and hysterectomy in prosthetic mitral valve thrombosis in pregnancy

Thrombolytic therapy and combined cesarean section and hysterectomy in prosthetic mitral valve thrombosis in pregnancy

Thrombolytic therapy and combined cesarean section and hysterectomy in prosthetic mitral valve thrombosis in pregnancy

Thrombolytic therapy and combined cesarean section and hysterectomy in prosthetic mitral valve thrombosis in pregnancy

Successful thrombectomy for thrombosis of aortic composite valve graft in pregnancy

Prosthetic heart valve thrombosis in pregnancy is a life-threatening complication whose management remains controversial and particularly difficult because of the additional challenge to save the fetus. Thrombolysis, thrombectomy, or prosthetic replacement are the currently available options. We report the case of a 17-week pregnant patient who was successfully treated by emergency open-heart thrombectomy for thrombosis of an aortic composite valve graft. Pregnancy was carried to term and a healthy baby was vaginally delivered 5 months later.

Prosthetic mitral valve thrombosis in pregnancy successfully treated with streptokinase

Prosthetic mitral valve thrombosis in pregnancy successfully treated with streptokinase