Prosthetic mitral valve thrombosis in pregnancy: from thrombolysis to anticoagulation.

Abstract

INTRODUCTION:

Pregnant women with mechanical prosthetic heart valves are at increased risk for valve thrombosis. Management decisions for this life-threatening complication are complex. Open-heart surgery has a very high risk of maternal mortality and fetal loss. Bleeding and embolic risks associated with thrombolytic agents, the limited efficacy of thrombolysis in certain subgroups, and a lack of experience in the setting of pregnancy raise important concerns.

CASE REPORT:

We report a case of mitral prosthetic valve thrombosis in early pregnancy, which was successfully treated with streptokinase. Ten years later, the same patient had an uneventful pregnancy, throughout which acenocoumarol was maintained.

CONCLUSION:

With this case we review the prevention (with oral anticoagulant therapy) and treatment of prosthetic valve thrombosis during pregnancy, which is important for both obstetrician and cardiologist.

• Authors: Gonçalo Cardoso, Carlos Aguiar, Maria João Andrade, Lino Patrício, Isabel Freire, Fátima Serrano, Rui Anjos, Miguel Mendes
• Journal: Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology (Rev Port Cardiol) Vol. 34 Issue 1 Pg. 71.e1-5 (Jan 2015) ISSN: 2174-2030 [Electronic] Portugal
• PMID: 25577659 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Chemical References

• Anticoagulants

Topics

• Anticoagulants (therapeutic use)
• Female
• Humans
• Mitral Valve
• Pregnancy
• Pregnancy Complications, Cardiovascular (drug therapy)
• Thrombolytic Therapy