The multidisciplinary management of a mechanical mitral valve thrombosis in pregnancy: a case report and review of the literature

Jennifer M Wright; Natalie Bottega; Judith Therrien; Roupen Hatzakorzian; Jean Buithieu; Dominique Shum-Tim; Karen Wou; Amale Ghandour; Patricia Pelletier; William Li Pi Shan; Ian Kaufman; Richard Brown; Isabelle Malhamé

doi:10.1093/ehjcr/ytac424

Wright, Jennifer M; Bottega, Natalie; Therrien, Judith; Hatzakorzian, Roupen; Buithieu, Jean;

European Heart Journal - Case Reports , Volume 6 (11): 1 – Nov 1, 2022

Abstract

BackgroundThe management of anticoagulation for mechanical heart valves during pregnancy poses a unique challenge. Mechanical valve thrombosis is a devastating complication for which surgery is often the treatment of choice. However, cardiac surgery for prosthetic valve dysfunction in pregnant patients confers a high risk of maternofetal morbidity and mortality.Case summaryA 39-year-old woman in her first pregnancy at 30 weeks gestation presented to hospital with a mechanical mitral valve thrombosis despite therapeutic anticoagulation with low-molecular-weight heparin. She underwent an emergent caesarean section followed immediately by a bioprosthetic mitral valve replacement. This occurred after careful planning and organization on the part of a large multidisciplinary team.DiscussionA proactive, rather than reactive, approach to the surgical management of a mechanical valve thrombosis in pregnancy will maximize the chances of successful maternal and fetal outcomes.

References (49)

C. Bhagra, R. D’Souza, C. Silversides (2016)

Valvular heart disease and pregnancy part II: management of prosthetic valves

Heart, 103

S. Vause, B. Clarke, C. Tower, C. Hay, M. Knight (2017)

Pregnancy outcomes in women with mechanical prosthetic heart valves: a prospective descriptive population based study using the United Kingdom Obstetric Surveillance System (UKOSS) data collection system

BJOG: An International Journal of Obstetrics & Gynaecology, 124

I. Hagen, J. Roos‐Hesselink, T. Ruys, W. Merz, S. Goland, H. Gabriel, M. Lelonek, O. Trojnarska, W. Mahmeed, H. Bálint, Z. Ashour, H. Baumgartner, E. Boersma, Mark Johnson, R. Hall (2015)

Pregnancy in Women With a Mechanical Heart Valve: Data of the European Society of Cardiology Registry of Pregnancy and Cardiac Disease (ROPAC).

Circulation

( Vause S , ClarkeB, TowerCL, HayC, KnightM. Pregnancy outcomes in women with mechanical prosthetic heart valves: a prospective descriptive population based study using the United Kingdom obstetric surveillance system (UKOSS) data collection system. Bjog2017;124:1411–1419.28019065)

Vause S , ClarkeB, TowerCL, HayC, KnightM. Pregnancy outcomes in women with mechanical prosthetic heart valves: a prospective descriptive population based study using the United Kingdom obstetric surveillance system (UKOSS) data collection system. Bjog2017;124:1411–1419.28019065, Vause S , ClarkeB, TowerCL, HayC, KnightM. Pregnancy outcomes in women with mechanical prosthetic heart valves: a prospective descriptive population based study using the United Kingdom obstetric surveillance system (UKOSS) data collection system. Bjog2017;124:1411–1419.28019065

( Vahanian A , BeyersdorfF, PrazF, MilojevicM, BaldusS, BauersachsJ, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, Jüni P, Pierard L, Prendergast BD, Sádaba JR, Tribouilloy C, Wojakowski W. 2021 ESC/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European society of cardiology (ESC) and the European association for cardio-thoracic surgery (EACTS). Rev Esp Cardiol (Engl Ed)2022;75:524.35636831)

Vahanian A , BeyersdorfF, PrazF, MilojevicM, BaldusS, BauersachsJ, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, Jüni P, Pierard L, Prendergast BD, Sádaba JR, Tribouilloy C, Wojakowski W. 2021 ESC/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European society of cardiology (ESC) and the European association for cardio-thoracic surgery (EACTS). Rev Esp Cardiol (Engl Ed)2022;75:524.35636831, Vahanian A , BeyersdorfF, PrazF, MilojevicM, BaldusS, BauersachsJ, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, Jüni P, Pierard L, Prendergast BD, Sádaba JR, Tribouilloy C, Wojakowski W. 2021 ESC/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European society of cardiology (ESC) and the European association for cardio-thoracic surgery (EACTS). Rev Esp Cardiol (Engl Ed)2022;75:524.35636831

N. Vitale, M. Feo, L. Santo, A. Pollice, N. Tedesco, M. Cotrufo (1999)

Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves.

Journal of the American College of Cardiology, 33 6

( Karthikeyan G , SenguttuvanNB, JosephJ, DevasenapathyN, BahlVK, AiranB. Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies. Eur Heart J2013;34:1557–1566.23329151)

Karthikeyan G , SenguttuvanNB, JosephJ, DevasenapathyN, BahlVK, AiranB. Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies. Eur Heart J2013;34:1557–1566.23329151, Karthikeyan G , SenguttuvanNB, JosephJ, DevasenapathyN, BahlVK, AiranB. Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies. Eur Heart J2013;34:1557–1566.23329151

( Nishimura RA , OttoCM, BonowRO, CarabelloBA, ErwinJPIII, FleisherLA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation2017;135:e1159–e1e95.28298458)

Nishimura RA , OttoCM, BonowRO, CarabelloBA, ErwinJPIII, FleisherLA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation2017;135:e1159–e1e95.28298458, Nishimura RA , OttoCM, BonowRO, CarabelloBA, ErwinJPIII, FleisherLA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation2017;135:e1159–e1e95.28298458

( Malhamé I , OthmanM, CasaisP, D’SouzaR, WaldRM, SilversidesCK, Sermer M, Shehata N. Communication from the ISTH SSC subcommittee on women’s health issues in thrombosis and haemostasis: a survey on anticoagulation for mechanical heart valves in pregnancy. J Thromb Haemost2021;19:859–864.33650243)

Malhamé I , OthmanM, CasaisP, D’SouzaR, WaldRM, SilversidesCK, Sermer M, Shehata N. Communication from the ISTH SSC subcommittee on women’s health issues in thrombosis and haemostasis: a survey on anticoagulation for mechanical heart valves in pregnancy. J Thromb Haemost2021;19:859–864.33650243, Malhamé I , OthmanM, CasaisP, D’SouzaR, WaldRM, SilversidesCK, Sermer M, Shehata N. Communication from the ISTH SSC subcommittee on women’s health issues in thrombosis and haemostasis: a survey on anticoagulation for mechanical heart valves in pregnancy. J Thromb Haemost2021;19:859–864.33650243

Preventive services task force evidence syntheses, formerly systematic evidence reviews. Aspirin use to prevent preeclampsia and related morbidity and mortality

( Russo G , GennariM, GavazzoniM, PedicinoD, PozzoliA, TaramassoM, Maisano F. Transcatheter mitral valve implantation: current Status and future perspectives. Circ Cardiovasc Interv2021;14:e010628.34407621)

Russo G , GennariM, GavazzoniM, PedicinoD, PozzoliA, TaramassoM, Maisano F. Transcatheter mitral valve implantation: current Status and future perspectives. Circ Cardiovasc Interv2021;14:e010628.34407621, Russo G , GennariM, GavazzoniM, PedicinoD, PozzoliA, TaramassoM, Maisano F. Transcatheter mitral valve implantation: current Status and future perspectives. Circ Cardiovasc Interv2021;14:e010628.34407621

R. D’Souza, J. Ostro, P. Shah, C. Silversides, A. Malinowski, K. Murphy, M. Sermer, N. Shehata (2017)

Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis

European Heart Journal, 38

( Sousa Gomes M , GuimarãesM, MontenegroN. Thrombolysis in pregnancy: a literature review. J Matern Fetal Neonatal Med2019;32:2418–2428.29378443)

Sousa Gomes M , GuimarãesM, MontenegroN. Thrombolysis in pregnancy: a literature review. J Matern Fetal Neonatal Med2019;32:2418–2428.29378443

Sousa Gomes M , GuimarãesM, MontenegroN. Thrombolysis in pregnancy: a literature review. J Matern Fetal Neonatal Med2019;32:2418–2428.29378443, Sousa Gomes M , GuimarãesM, MontenegroN. Thrombolysis in pregnancy: a literature review. J Matern Fetal Neonatal Med2019;32:2418–2428.29378443

( D’Souza R , OstroJ, ShahPS, SilversidesCK, MalinowskiA, MurphyKE, Sermer M, Shehata N. Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis. Eur Heart J2017;38:1509–1516.28329059)

D’Souza R , OstroJ, ShahPS, SilversidesCK, MalinowskiA, MurphyKE, Sermer M, Shehata N. Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis. Eur Heart J2017;38:1509–1516.28329059, D’Souza R , OstroJ, ShahPS, SilversidesCK, MalinowskiA, MurphyKE, Sermer M, Shehata N. Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis. Eur Heart J2017;38:1509–1516.28329059

( Cannegieter SC , RosendaalFR, WintzenAR, van der MeerFJ, VandenbrouckeJP, BriëtE. Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med1995;333:11–17.7776988)

Cannegieter SC , RosendaalFR, WintzenAR, van der MeerFJ, VandenbrouckeJP, BriëtE. Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med1995;333:11–17.7776988

Cannegieter SC , RosendaalFR, WintzenAR, van der MeerFJ, VandenbrouckeJP, BriëtE. Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med1995;333:11–17.7776988, Cannegieter SC , RosendaalFR, WintzenAR, van der MeerFJ, VandenbrouckeJP, BriëtE. Optimal oral anticoagulant therapy in patients with mechanical heart valves. N Engl J Med1995;333:11–17.7776988

Vahanian (2022)

524

Rev Esp Cardiol (Engl Ed), 75

( Otto CM , NishimuraRA, BonowRO, CarabelloBA, ErwinJPIII, GentileF, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A, Toly C. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. J Am Coll Cardiol2021;77:e25–e197.33342586)

Otto CM , NishimuraRA, BonowRO, CarabelloBA, ErwinJPIII, GentileF, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A, Toly C. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. J Am Coll Cardiol2021;77:e25–e197.33342586, Otto CM , NishimuraRA, BonowRO, CarabelloBA, ErwinJPIII, GentileF, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM III, Thompson A, Toly C. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. J Am Coll Cardiol2021;77:e25–e197.33342586

( Özkan M , ÇakalB, KarakoyunS, GürsoyOM, ÇevikC, KalçıkM, Oğuz AE, Gündüz S, Astarcioglu MA, Aykan A, Bayram Z, Biteker M, Kaynak E, Kahveci G, Duran NE, Yıldız M. Thrombolytic therapy for the treatment of prosthetic heart valve thrombosis in pregnancy with low-dose, slow infusion of tissue-type plasminogen activator. Circulation2013;128:532–540.23812180)

Özkan M , ÇakalB, KarakoyunS, GürsoyOM, ÇevikC, KalçıkM, Oğuz AE, Gündüz S, Astarcioglu MA, Aykan A, Bayram Z, Biteker M, Kaynak E, Kahveci G, Duran NE, Yıldız M. Thrombolytic therapy for the treatment of prosthetic heart valve thrombosis in pregnancy with low-dose, slow infusion of tissue-type plasminogen activator. Circulation2013;128:532–540.23812180, Özkan M , ÇakalB, KarakoyunS, GürsoyOM, ÇevikC, KalçıkM, Oğuz AE, Gündüz S, Astarcioglu MA, Aykan A, Bayram Z, Biteker M, Kaynak E, Kahveci G, Duran NE, Yıldız M. Thrombolytic therapy for the treatment of prosthetic heart valve thrombosis in pregnancy with low-dose, slow infusion of tissue-type plasminogen activator. Circulation2013;128:532–540.23812180

( Henderson JT , VescoKK, SengerCA, ThomasRG, RedmondNUS. Preventive services task force evidence syntheses, formerly systematic evidence reviews. Aspirin use to prevent preeclampsia and related morbidity and mortality. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021.)

Henderson JT , VescoKK, SengerCA, ThomasRG, RedmondNUS. Preventive services task force evidence syntheses, formerly systematic evidence reviews. Aspirin use to prevent preeclampsia and related morbidity and mortality. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021., Henderson JT , VescoKK, SengerCA, ThomasRG, RedmondNUS. Preventive services task force evidence syntheses, formerly systematic evidence reviews. Aspirin use to prevent preeclampsia and related morbidity and mortality. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021.

( Jha N , JhaAK, Chand ChauhanR, ChauhanNS. Maternal and fetal outcome after cardiac operations during pregnancy: a meta-analysis. Ann Thorac Surg2018;106:618–626.29660361)

Jha N , JhaAK, Chand ChauhanR, ChauhanNS. Maternal and fetal outcome after cardiac operations during pregnancy: a meta-analysis. Ann Thorac Surg2018;106:618–626.29660361

Jha N , JhaAK, Chand ChauhanR, ChauhanNS. Maternal and fetal outcome after cardiac operations during pregnancy: a meta-analysis. Ann Thorac Surg2018;106:618–626.29660361, Jha N , JhaAK, Chand ChauhanR, ChauhanNS. Maternal and fetal outcome after cardiac operations during pregnancy: a meta-analysis. Ann Thorac Surg2018;106:618–626.29660361

( Regitz-Zagrosek V , Roos-HesselinkJW, BauersachsJ, Blomström-LundqvistC, CífkováR, De BonisM, Iung B, Johnson MR, Kintscher U, Kranke P, Lang IM, Morais J, Pieper PG, Presbitero P, Price S, Rosano G, Seeland U, Simoncini T, Swan L, Warnes CA, ESC Scientific Document Group. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J2018;39:3165–3241.30165544)

Regitz-Zagrosek V , Roos-HesselinkJW, BauersachsJ, Blomström-LundqvistC, CífkováR, De BonisM, Iung B, Johnson MR, Kintscher U, Kranke P, Lang IM, Morais J, Pieper PG, Presbitero P, Price S, Rosano G, Seeland U, Simoncini T, Swan L, Warnes CA, ESC Scientific Document Group. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J2018;39:3165–3241.30165544, Regitz-Zagrosek V , Roos-HesselinkJW, BauersachsJ, Blomström-LundqvistC, CífkováR, De BonisM, Iung B, Johnson MR, Kintscher U, Kranke P, Lang IM, Morais J, Pieper PG, Presbitero P, Price S, Rosano G, Seeland U, Simoncini T, Swan L, Warnes CA, ESC Scientific Document Group. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J2018;39:3165–3241.30165544

M. Özkan, B. Çakal, S. Karakoyun, O. Gürsoy, C. Çevik, M. Kalçık, A. Oğuz, S. Gündüz, M. Astarcıoğlu, A. Aykan, Z. Bayram, M. Biteker, E. Kaynak, G. Kahveci, N. Duran, M. Yıldız (2013)

Thrombolytic Therapy for the Treatment of Prosthetic Heart Valve Thrombosis in Pregnancy With Low-Dose, Slow Infusion of Tissue-Type Plasminogen Activator

Circulation, 128

V. Regitz-Zagrosek, C. Lundqvist, C. Borghi, R. Cífková, Rafael Ferreira, J. Foidart, J. Gibbs, C. Gohlke-Baerwolf, B. Gorenek, B. Iung, M. Kirby, Angela Maas, J. Morais, P. Nihoyannopoulos, P. Pieper, P. Presbitero, J. Roos‐Hesselink, M. Schaufelberger, U. Seeland, L. Torracca (2012)

ESC Guidelines on the Management of Cardiovascular Diseases During Pregnancy

Revista Espanola De Cardiologia, 65

J. Grewal, J. Windram, Natalie Bottega, M. Sermer, D. Spears, C. Silversides, S. Siu, L. Swan (2021)

Canadian Cardiovascular Society: Clinical Practice Update on Cardiovascular Management of the Pregnant Patient.

The Canadian journal of cardiology

C. Otto, Rick Nishimura, R. Bonow, B. Carabello, J. Erwin, F. Gentile, H. Jneid, E. Krieger, M. Mack, Christopher McLeod, P. O'Gara, V. Rigolin, T. Sundt, Annemarie Thompson, Christopher Toly (2020)

2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

Circulation

( Batra J , ItagakiS, EgorovaNN, ChikweJ. Outcomes and long-term effects of pregnancy in women with biologic and mechanical valve prostheses. Am J Cardiol2018;122:1738–1744.30449326)

Batra J , ItagakiS, EgorovaNN, ChikweJ. Outcomes and long-term effects of pregnancy in women with biologic and mechanical valve prostheses. Am J Cardiol2018;122:1738–1744.30449326

Batra J , ItagakiS, EgorovaNN, ChikweJ. Outcomes and long-term effects of pregnancy in women with biologic and mechanical valve prostheses. Am J Cardiol2018;122:1738–1744.30449326, Batra J , ItagakiS, EgorovaNN, ChikweJ. Outcomes and long-term effects of pregnancy in women with biologic and mechanical valve prostheses. Am J Cardiol2018;122:1738–1744.30449326

V. Regitz-Zagrosek, J. Roos‐Hesselink, J. Bauersachs, C. Blomström‐Lundqvist, R. Cífková, M. Bonis, B. Iung, Mark Johnson, U. Kintscher, P. Kranke, I. Lang, J. Morais, P. Pieper, P. Presbitero, S. Price, G. Rosano, U. Seeland, T. Simoncini, L. Swan, C. Warnes (2018)

2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy.

European heart journal, 39 34

S. Cannegieter, F. Rosendaal, A. Wintzen, F. Meer, J. Vandenbroucke, E. Briët (1995)

Optimal oral anticoagulant therapy in patients with mechanical heart valves.

The New England journal of medicine, 333 1

( Windram J , GrewalJ, BottegaN, SermerM, SpearsD, SwanL, Siu SC, Silversides C. Canadian Cardiovascular society: clinical practice update on cardiovascular management of the pregnant patient. Can J Cardiol2021;37:1886–1901.34217807)

Windram J , GrewalJ, BottegaN, SermerM, SpearsD, SwanL, Siu SC, Silversides C. Canadian Cardiovascular society: clinical practice update on cardiovascular management of the pregnant patient. Can J Cardiol2021;37:1886–1901.34217807, Windram J , GrewalJ, BottegaN, SermerM, SpearsD, SwanL, Siu SC, Silversides C. Canadian Cardiovascular society: clinical practice update on cardiovascular management of the pregnant patient. Can J Cardiol2021;37:1886–1901.34217807

( Bui P , MascaroPG, Henao-MejiaJ, PatelS. Preemptive ECMO cannulation in a patient with severe left ventricular systolic dysfunction undergoing cesarean delivery. Case Rep Anesthesiol2019;2019:1–5.)

Bui P , MascaroPG, Henao-MejiaJ, PatelS. Preemptive ECMO cannulation in a patient with severe left ventricular systolic dysfunction undergoing cesarean delivery. Case Rep Anesthesiol2019;2019:1–5.

Bui P , MascaroPG, Henao-MejiaJ, PatelS. Preemptive ECMO cannulation in a patient with severe left ventricular systolic dysfunction undergoing cesarean delivery. Case Rep Anesthesiol2019;2019:1–5., Bui P , MascaroPG, Henao-MejiaJ, PatelS. Preemptive ECMO cannulation in a patient with severe left ventricular systolic dysfunction undergoing cesarean delivery. Case Rep Anesthesiol2019;2019:1–5.

( Pieper PG . Use of medication for cardiovascular disease during pregnancy. Nat Rev Cardiol2015;12:718–729.26585398)

Pieper PG . Use of medication for cardiovascular disease during pregnancy. Nat Rev Cardiol2015;12:718–729.26585398

Pieper PG . Use of medication for cardiovascular disease during pregnancy. Nat Rev Cardiol2015;12:718–729.26585398, Pieper PG . Use of medication for cardiovascular disease during pregnancy. Nat Rev Cardiol2015;12:718–729.26585398

N. Jha, A. Jha, Ramesh Chauhan, N. Chauhan (2018)

Maternal and Fetal Outcome After Cardiac Operations During Pregnancy: A Meta-Analysis.

The Annals of thoracic surgery, 106 2

( Chan WS , AnandS, GinsbergJS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med2000;160:191–196.10647757)

Chan WS , AnandS, GinsbergJS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med2000;160:191–196.10647757

Chan WS , AnandS, GinsbergJS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med2000;160:191–196.10647757, Chan WS , AnandS, GinsbergJS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med2000;160:191–196.10647757

Marina Gomes, M. Guimarães, N. Montenegro (2019)

Thrombolysis in pregnancy: a literature review

The Journal of Maternal-Fetal & Neonatal Medicine, 32

P. Pieper (2015)

Use of medication for cardiovascular disease during pregnancy

Nature Reviews Cardiology, 12

( Bhagra CJ , D’SouzaR, SilversidesCK. Valvular heart disease and pregnancy part II: management of prosthetic valves. Heart2017;103:244–252.27670966)

Bhagra CJ , D’SouzaR, SilversidesCK. Valvular heart disease and pregnancy part II: management of prosthetic valves. Heart2017;103:244–252.27670966

Bhagra CJ , D’SouzaR, SilversidesCK. Valvular heart disease and pregnancy part II: management of prosthetic valves. Heart2017;103:244–252.27670966, Bhagra CJ , D’SouzaR, SilversidesCK. Valvular heart disease and pregnancy part II: management of prosthetic valves. Heart2017;103:244–252.27670966

W. Chan, S. Anand, Jeffrey Ginsberg (2000)

Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature.

Archives of internal medicine, 160 2

(2021)

Transcatheter mitral valve implantation: current Status and future perspectives

( van Hagen IM , Roos-HesselinkJW, RuysTP, MerzWM, GolandS, GabrielH, Lelonek M, Trojnarska O, Al Mahmeed WA, Balint HO, Ashour Z, Baumgartner H, Boersma E, Johnson MR, Hall R, ROPAC Investigators and the EURObservational Research Programme (EORP) Team. Pregnancy in women with a mechanical heart valve: data of the European society of cardiology registry of pregnancy and cardiac disease (ROPAC). Circulation2015;132:132–142.26100109)

van Hagen IM , Roos-HesselinkJW, RuysTP, MerzWM, GolandS, GabrielH, Lelonek M, Trojnarska O, Al Mahmeed WA, Balint HO, Ashour Z, Baumgartner H, Boersma E, Johnson MR, Hall R, ROPAC Investigators and the EURObservational Research Programme (EORP) Team. Pregnancy in women with a mechanical heart valve: data of the European society of cardiology registry of pregnancy and cardiac disease (ROPAC). Circulation2015;132:132–142.26100109, van Hagen IM , Roos-HesselinkJW, RuysTP, MerzWM, GolandS, GabrielH, Lelonek M, Trojnarska O, Al Mahmeed WA, Balint HO, Ashour Z, Baumgartner H, Boersma E, Johnson MR, Hall R, ROPAC Investigators and the EURObservational Research Programme (EORP) Team. Pregnancy in women with a mechanical heart valve: data of the European society of cardiology registry of pregnancy and cardiac disease (ROPAC). Circulation2015;132:132–142.26100109

J. Batra, Shinobu Itagaki, N. Egorova, J. Chikwe (2018)

Outcomes and Long-term Effects of Pregnancy in Women With Biologic and Mechanical Valve Prostheses.

The American journal of cardiology, 122 10

Phuong Bui, P. Mascaro, Juanita Henao-Mejia, S. Patel (2019)

Preemptive ECMO Cannulation in a Patient with Severe Left Ventricular Systolic Dysfunction Undergoing Cesarean Delivery

Case Reports in Anesthesiology, 2019

Zhe Xu, Jin Fan, Xin Luo, Wenbin Zhang, Jun Ma, Yu-bi Lin, Shao-hong Ma, Xin Chen, Zhi‐ping Wang, J. Ou, Xi Zhang (2016)

Anticoagulation Regimens During Pregnancy in Patients With Mechanical Heart Valves: A Systematic Review and Meta-analysis.

The Canadian journal of cardiology, 32 10

( Vitale N , De FeoM, De SantoLS, PolliceA, TedescoN, CotrufoM. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. J Am Coll Cardiol1999;33:1637–1641.10334435)

Vitale N , De FeoM, De SantoLS, PolliceA, TedescoN, CotrufoM. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. J Am Coll Cardiol1999;33:1637–1641.10334435, Vitale N , De FeoM, De SantoLS, PolliceA, TedescoN, CotrufoM. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. J Am Coll Cardiol1999;33:1637–1641.10334435

( Xu Z , FanJ, LuoX, ZhangWB, MaJ, LinYB, Ma SH, Chen X, Wang ZP, Ou JS, Zhang X. Anticoagulation regimens during pregnancy in patients with mechanical heart valves: a systematic review and meta-analysis. Can J Cardiol2016;32:1248.e1–.e9.26927861)

Xu Z , FanJ, LuoX, ZhangWB, MaJ, LinYB, Ma SH, Chen X, Wang ZP, Ou JS, Zhang X. Anticoagulation regimens during pregnancy in patients with mechanical heart valves: a systematic review and meta-analysis. Can J Cardiol2016;32:1248.e1–.e9.26927861, Xu Z , FanJ, LuoX, ZhangWB, MaJ, LinYB, Ma SH, Chen X, Wang ZP, Ou JS, Zhang X. Anticoagulation regimens during pregnancy in patients with mechanical heart valves: a systematic review and meta-analysis. Can J Cardiol2016;32:1248.e1–.e9.26927861

Otto (2021)

e25

J Am Coll Cardiol, 77

Rick Nishimura, C. Otto, R. Bonow, B. Carabello, J. Erwin, L. Fleisher, H. Jneid, M. Mack, Christopher McLeod, P. O'Gara, V. Rigolin, T. Sundt, Annemarie Thompson (2017)

2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

Journal of the American College of Cardiology, 70 2

G. Karthikeyan, N. Senguttuvan, J. Joseph, N. Devasenapathy, V. Bahl, B. Airan (2013)

Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies.

European heart journal, 34 21

A. Vahanian, F. Beyersdorf, F. Praz, M. Milojevic, S. Baldus, J. Bauersachs, D. Capodanno, L. Conradi, M. Bonis, R. Paulis, V. Delgado, N. Freemantle, M. Gilard, K. Haugaa, A. Jeppsson, P. Jüni, L. Pierard, B. Prendergast, J. Sádaba, C. Tribouilloy, W. Wojakowski (2022)

2021 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS).

Revista espanola de cardiologia, 75 6

I. Malhamé, M. Othman, P. Casais, R. D’Souza, R. Wald, C. Silversides, M. Sermer, N. Shehata (2021)

Communication from the ISTH SSC Subcommittee on Women's Health Issues in Thrombosis and Haemostasis: A Survey on Anticoagulation for Mechanical Heart Valves in Pregnancy

Journal of Thrombosis and Haemostasis, 19

Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

The multidisciplinary management of a mechanical mitral valve thrombosis in pregnancy: a case report and review of the literature

The multidisciplinary management of a mechanical mitral valve thrombosis in pregnancy: a case report and review of the literature