Prosthetic Heart Valves and Pregnancy

Comparison between two different regimens of anticoagulants for pregnant women with prosthetic heart valves

“…Substitution of heparin for oral anticoagulant in the first trimester only is effective in stopping warfarin embryopathy, but high rates of late fetal loss and stillbirth rates remain with maternal thromboembolic complications in 9.5% of pregnancies. [12][13][14][15][16] In 2002, Food and Drug Administration instructed a threatening in the package insert of enoxaparin, which specified that the product is not recommended for antithrombotic prophylaxis in patients with mechanical valves; as there are cases of mechanical valve thrombosis, maternal and fetal deaths were reported with the use of this drug; and that in pregnant women who received this drug, both teratogenic and non-teratogenic effects have been reported. Even so, the data on the use of enoxaparin in this subgroup of patients is mixed with literature available to both support and contraindicate its use.…”

Operación de Ross en Chile

“…Datos actuales muestran que la durabilidad entre las prótesis biológicas de pericardio de bovino y válvulas aórticas porcinas son comparables 24 27 . Por últi mo, el embarazo, factor importante en pacientes jóvenes, acelera la degeneración de estas prótesis 28 . Con respecto al bajo riesgo de reoperación, sólo es válido para la primera reoperación, aumentando para las siguientes intervenciones 29 .…”

Guidelines for Perioperative Cardiovascular Evaluation and Management for Noncardiac Surgery (JCS 2014) ― Digest Version ―

“…55 Diuretics should be used carefully, since excessive use of them may cause hypovolemia and result in suboptimal uteroplacental circulation. 49, 56 Percutaneous mitral valvuloplasty may be indicated for severe mitral stenosis before pregnancy. When heart failure not responding to medical therapy develops during pregnancy, physicians should consider percutaneous mitral valvuloplasty.…”