[HSF] Pegnancy and LA Clot

[Ani Anyanwu]

What is her right ventricular function like? 

I think you should first find out her intentions regarding her pregnancy. Personally I think she should be advised to have a termination, as continuation of the pregnancy will place her at high cardiovascular risk in 3rd trimester regardless of the success of this procedure (because of severe pulm HTN, probable RV dysfunction; both likely to progress in late pregnancy despite intervention on mitral).

Other option is to anticoagulate and then do balloon valvuloplasty for now with plan for staged surgery post-partum however this strategy again places her at high cardiovascular risk in third trimester.

Ani
  ----- Original Message ----- 
  From: sekhar le<mailto:sekharle2006 at hotmail.com> 
  To: OpenHeart-L at lists.hsforum.com<mailto:OpenHeart-L at lists.hsforum.com> 
  Sent: Friday, April 27, 2007 3:13 PM
  Subject: [HSF] Pegnancy and LA Clot


  We have a 40 yrs female admitted for elective mitral valve replacement for 
  severe MS[MVOA-1cm],severe TR, PA pressure 75..She is in sinus rhythym and 
  had CVA 5 months back.TEE showed a big  LA clot.
  Incidentally it was realised she is 3 months pregnant  by ultra sound[had 
  h/o irregular periods for 2 yrs which probably lead to late recognition of 
  pregnancy].
  How should we proceed? Ignore pregnancy and opt for urgent MVR?

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