The use of low molecular weight heparin during pregnancy in patients with mechanical heart valves carries potential risk for valve thrombosis: a report of three cases.

Abstract

Pregnancy is associated with an increased risk of valve thrombosis, hemorrhagic complications, and offspring complications in patients with metallic prosthetic heart valve (MHV). Warfarin treatment is the best regimen against thromboembolic complications, but its use in the first trimester can result in embryopathy. Low molecular weight heparin (LMWH) does not cross the placenta and has some potential advantages. However, the pharmacokinetics of LMWHs change during pregnancy, and serial monitoring of anti-Xa levels is strongly recommended. Despite this recommendation, LMWH therapy in a fixed dose is still used in pregnant women with MHV without monitoring anti-Xa activity in clinical practice. We present three cases of MHV thrombosis occurring while on therapy with LMWH during pregnancy. One of these patients showed cerebrovascular event, one presented with pulmonary edema, and one underwent reoperation for MHV thrombosis.

• Authors: Utku Senol, Taner Ulus, Alparslan Birdane, Yüksel Cavuşoğlu
• Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir (Turk Kardiyol Dern Ars) Vol. 42 Issue 3 Pg. 294-8 (Apr 2014) ISSN: 1016-5169 [Print] Turkey
• PMID: 24769825 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticoagulants
• Heparin, Low-Molecular-Weight

Topics

• Adolescent
• Adult
• Anticoagulants (adverse effects, therapeutic use)
• Female
• Heart Valve Diseases (chemically induced)
• Heart Valve Prosthesis (adverse effects)
• Heparin, Low-Molecular-Weight (adverse effects, therapeutic use)
• Humans
• Pregnancy
• Thrombosis (chemically induced)