[HSF] MVR in a young lady

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Asian Cardiovasc Thorac Ann 2000;8:127-129
© 2000 Asia Publishing EXchange Pte Ltd

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ORIGINAL CONTRIBUTION

Pregnancy With St. Jude Medical Mitral Valve Prosthesis
Birol Yamak, MD, Mustafa Emir, MD, Tulga A Ulus, MD, Ayen Aksöyek, MD, Zafer 
Ican, MD, S Fehmi Katirciolu, MD, Ouz Tademir, MD
Department of Cardiovascular Surgery
Türkiye Yüksek htisas Hospital
Ankara, Turkey
For reprint information contact: Tulga A Ulus, MD Tel: 90 532 522 1520 Fax: 
90 312 229 0148 email: uluss at yahoo.com Nide Sokak 20/6, Ulus Apt., Dikmen, 
Ankara 06460, Turkey.
>From 1986 to 1995, 513 young women of childbearing age (11 to 45 years) 
underwent mitral valve replacement with a bileaflet St. Jude Medical 
prosthesis. Twenty-one patients became pregnant within 3 years 
postoperatively. The mean age of these patients at the onset of pregnancy 
was 27 ± 8 years (range, 16 to 43 years). Follow-up was complete for all 
pregnant patients. Of 11 who continued to take warfarin during pregnancy, 
one had a premature delivery, 2 had spontaneous abortions, and 8 had 
therapeutic abortions. Five patients who ceased oral anticoagulant therapy 
had normal deliveries but 4 underwent reoperation for valve thrombosis 
postnatally, with concurrent left hemiplegia in one case. The other 5 
patients adhered to an anticoagulation protocol for pregnancy; there were 3 
normal deliveries, 1 premature birth, and 1 abortion. There is a high risk 
of thromboembolism in patients with mechanical heart valves whose 
anticoagulants are interrupted during pregnancy. We believe that careful 
supervision can reduce maternal morbidity and mortality.