Pregnancy and bioprostheses: Influence on structural valve deterioration

Jamieson, W.R. Eric; Miller, D. Craig; Akins, Cary W.; Munro, A. Ian; Glower, Donald D.; Moore, Kathleen A.; Henderson, Charmaine

doi:10.1016/0003-4975(95)00308-8

Cited by 66 publications

(36 citation statements)

References 14 publications

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“…This is consistent with previous studies. 4,11,19 In contrast to valve survival, the unadjusted long-term survival of women was greater in those with bioprosthetic rather than mechanical valves. After adjustment for potential confounding variables, the trend for increased patient survival in women with bioprosthetic compared with those with mechanical valves persisted.…”

Section: Discussionmentioning

confidence: 94%

“…This is in keeping with a previous large controlled study, which found no increase in structural valvular deterioration of bioprosthetic valves with pregnancy. 4 The association of pregnancy with greater survival of women is likely to be due to patient selection rather than pregnancy conferring a specific health benefit.…”

Section: Discussionmentioning

confidence: 99%

“…1,3 Women with bioprosthetic valves need only short-duration anticoagulation after valve replacement, provided that sinus rhythm is maintained, and usually have a successful pregnancy outcome. 4 However, as young patients with bioprosthetic valves are at risk of early reoperation because of increased structural valvular deterioration, 11 there is reluctance to use these valves in the young. 12 Concern has also been raised that pregnancy may hasten the rate of structural deterioration of bioprosthetic valves.…”

Section: See P 2613mentioning

confidence: 99%

“…13 When this study was extended, no difference was found in the rate of structural valvular deterioration with pregnancy. 4 Homograft valves are used in the aortic position and do not require long-term anticoagulation. 14 There is limited informa-tion on the survival and valve complications of young women with homografts and no information on the effect of pregnancy on valve survival.…”

Section: See P 2613mentioning

confidence: 99%

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

et al. 1999

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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)

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: See P 2613mentioning

confidence: 99%

Section: See P 2613mentioning

confidence: 99%

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

et al. 1999

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Ávila

Rossi

Ramires

et al. 2003

Clinical Cardiology

230

110

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SummaryBackground: Previously, the high maternal mortality in cardiac patients who became pregnant prompted the assertion: Women with an abnormal heart should not become pregnant. This long-standing notion needs to be revised today.Hypothesis: The study was undertaken to ascertain the experience with a large series of pregnant women with cardiac disease cared for in the same referral center.Methods: From 1989 to 1999, 1,000 pregnant women with heart disease were followed by the same clinical and obstetric team. The cardiac diseases included rheumatic heart disease (55.7%), congenital heart disease (19.1%), Chagas' disease (8.5%), cardiac arrhythmias (5.1%), cardiomyopathies (4.3%), and others (7.3%).Results: Of the pregnant women studied, 765 (76.5%) experienced no cardiovascular events during the study; 235 (23.5%) patients had the following cardiovascular complications: congestive heart failure (12.3%), cardiac arrhythmias (6%), thromboembolism (1.9%), angina (1.4%), hypoxemia (0.7%), infective endocarditis (0.5%), and other complications (0.7%). Clinical treatment allowed adequate management in 161 (68.8%) patients; however, 46 (19.6%) patients underwent interventional procedures because of refractory complications. The general maternal mortality rate was 2.7%. Of the 915 (91.5%) infants who were discharged, 119 (13%) were premature.

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