Document Detail

Mechanical prosthetic mitral valve thrombosis in a first trimester pregnant woman.
MedLine Citation:
PMID:  19822606     Owner:  NLM     Status:  MEDLINE    
Pregnant women with a mechanical heart prosthesis are at a higher risk of thromboembolic complications. The optimal anticoagulation strategy in this setting remains unclear. When prosthesis thrombosis happens and cardiac surgery must be performed, the risk of fetal mortality is high. Special attention must be paid to improve the placental perfusion during cardiopulmonary bypass (CPB) in order to improve fetal outcomes. A 31-year-old woman, nine weeks pregnant, was admitted to our institution due to a mitral mechanical prosthesis thrombosis. She had been receiving low molecular weight heparin (LMWH) since pregnancy was detected. She underwent a mitral valve replacement with CPB at 34 degrees C and a short cardiac arrest time. Both mother and fetus survived. We briefly review the different anticoagulation options during pregnancy and perfusion strategies on CPB to improve fetal outcomes.
Manuel Carnero-Alcázar; Fernando Reguillo-Lacruz; Lorena Montes-Villalobos; José Enrique Rodríguez-Hernández
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-10-12
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-18     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  116-8     Citation Subset:  IM    
Department of Cardiac Surgery, Hospital Clínico San Carlos, Madrid, Spain.
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MeSH Terms
Anticoagulants / therapeutic use
Cardiopulmonary Bypass* / adverse effects
Device Removal
Fetal Death / prevention & control
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects,  instrumentation*
Heparin, Low-Molecular-Weight / therapeutic use
Placental Circulation
Pregnancy Complications, Cardiovascular / etiology,  physiopathology,  surgery*,  ultrasonography
Pregnancy Trimester, First
Prosthesis Failure
Thrombosis / etiology,  physiopathology,  surgery*,  ultrasonography
Treatment Outcome
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight
Comment In:
Interact Cardiovasc Thorac Surg. 2010 Jan;10(1):118-9   [PMID:  20019046 ]
Interact Cardiovasc Thorac Surg. 2010 Jan;10(1):119   [PMID:  20019048 ]
Interact Cardiovasc Thorac Surg. 2010 Jan;10(1):118   [PMID:  20019047 ]

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