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Thorax Centre, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
Department of Cardiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
P.G. Pieper Department of Cardiology, Thorax Centre, University Medical Center Groningen, PB 30.001, 9700 RB Groningen, the Netherlands
Pregnancy in women with mechanical valve prostheses has a high maternal complication rate including valve thrombosis and death. Coumarin derivatives are relatively safe for the mother with a lower incidence of valve thrombosis than un-fractionated and low-molecular-weight heparin, but carry the risk of embryopathy, which is probably dose-dependent. The different anticoagulation regimens are discussed in this review. When valve thrombosis occurs during pregnancy, thrombolysis is the preferable therapeutic option. Bioprostheses have a more favourable pregnancy outcome than mechanical prostheses but due to the high re-operation rate in young women they do not constitute the ideal alternative. When women with native valve stenosis need pre-pregnancy intervention, mitral balloon valvuloplasty is the best option in mitral stenosis, while the Ross operation or homograft implantation may be the preferable surgical regimen in aortic stenosis. (Neth Heart J 2008;16:406-11.)
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- Pregnancy in women with prosthetic heart valves
P. G. Pieper
A. P. Van Dijk
- Bohn Stafleu van Loghum