Patient–Prosthesis Mismatch in Pregnancy

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 123; no. 2, PART 2 Suppl 2; pp. 441 - 443
• Main Authors: Johnston, Robert C, Swank, Morgan L, Shrivastava, Vineet K, Hameed, Afshan B
• Format: Journal Article
• Language: English
• Published: United States by The American College of Obstetricians and Gynecologists 01.02.2014
• Subjects: Adult; Aortic Valve - transplantation; Female; Fetal Death; Heart Valve Prosthesis - adverse effects; Heart Valve Prosthesis Implantation; Humans; Postoperative Complications - etiology; Pregnancy; Pregnancy Complications, Cardiovascular - diagnosis; Pregnancy Complications, Cardiovascular - etiology; Pregnancy Complications, Cardiovascular - therapy; Prosthesis Failure - etiology; Reoperation
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0000000000000074

BACKGROUND:Patient–prosthesis mismatch is a known and severe complication after aortic valve repair in the general population. There is a paucity of literature regarding this condition in pregnancy. CASE:We present the clinical course of a pregnant woman with severe patient–prosthesis mismatch after aortic valve replacement. After extensive workup, the patient underwent aortic valve replacement, enlargement of the aortic root, and placement of a larger prosthetic valve at 21 weeks of gestation. Her postoperative course was complicated by fetal death. CONCLUSION:Cardiopulmonary bypass and aortic valve replacement present a multitude of risks to maternal and fetal health. The obstetrician managing pregnant women with prosthetic heart valves should be aware of the complications that may arise, including patient–prosthesis mismatch.