Long-Term Survival and Valve-Related Complications in Young Women With Cardiac Valve Replacements

Abstract

Background-The type of cardiac valve replacement associated with the lowest health risks for young women who may undergo pregnancies is unknown. We investigated which valve type was associated with greatest patient and valve survival and the effect of pregnancy on valve loss. Methods and Results-In this retrospective study, all women 12 to 35 years old who underwent valve replacements between 1972 and 1992 at Greenlane Hospital were identified, and follow-up was available in 93%. The 232 women were followed up for 1499 patient-years. Ten-year survival of women with mechanical (nϭ178), bioprosthetic (nϭ73), and homograft (nϭ72)

Pregnancy in patients with heart disease: Experience with 1,000 cases

“…Indeed, the results of a contemporary prospective and comparative 5-year study did not indicate that pregnancy contributes to bioprosthesis deterioration, 17 consistent with findings in other studies. [18][19][20] The conflicting conclusions concerning the role of pregnancy in accelerating structural bioprosthetic failure may be due to differences in study population and data collection.…”

Heart valve bioprothesis; effect of different acellularizations methods on the biomechanical and morphological properties of porcine aortic and pulmonary valve

“…Although many types of valve prosthesis are developed, in many cases, the most important problem, which strongly determines the valve function and durability, is the body reaction to a foreign material. The commonly used heart valve prostheses, both biological and mechanical, have many limitations, such as: an infection risk, thromboembolism, the long-life anti-coagulation therapy [1,2]. A possible cause of the valve prosthesis degeneration can also be an immune response to the viable cells in a cryopreserved allograft [3].…”

“…Both of them have many disadvantages. Tissue engineering is a promising tool for the creation of a new type of the heart valve bioprothesis [1]. The biological scaffold composed of decellularized tissue has been successfully used for the constructions of the valve prosthesis.…”

Risks and Pregnancy Outcome in Women With Prosthetic Mechanical Heart Valve Replacement

“…Currently, biological heart valve replacement is being performed in young women because it does not require anticoagulation therapy, 3 but biological valves require replacement after 10-15, 4 whereas mechanical valves do not, although they require long-term anticoagulation therapy to minimize the high risk of associated thromboembolic complications. Pregnancy is a physiologic hypercoagulable state that further increases the risk of functional deterioration of the valve.…”

“…Pregnancy is a physiologic hypercoagulable state that further increases the risk of functional deterioration of the valve. There are several reports of the risks and pregnancy outcomes in women with mechanical heart valve replacement in Western countries, [1][2][3]6,7 but only limited data are available in Japan.…”