Outcomes of prosthetic valve replacement in women of child-bearing age

• Published in: Surgery Today Vol. 47; no. 6; pp. 755 - 761
• Main Authors: Kataoka, Go, Asano, Ryota, Sato, Atsuhiko, Tatsuishi, Wataru, Nakano, Kiyoharu
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Science and Business Media LLC 01.06.2017; Springer Japan
• Subjects: Adult; Age Factors; Aortic Valve; Aortic Valve - surgery; Aortic Valve Insufficiency; Aortic Valve Insufficiency - surgery; Aortic Valve Stenosis; Aortic Valve Stenosis - surgery; Bioprosthesis; Child; Child, Preschool; Female; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Medicine; Medicine & Public Health; Mitral Valve; Mitral Valve - surgery; Original Article; Pregnancy; Pregnancy Outcome; Reoperation; Reoperation - statistics & numerical data; Risk; Surgery; Surgical Oncology; Young Adult; Pregnancy; Young woman; Prosthetic valve
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-016-1445-y

Purpose The outcomes of pregnancy are more favorable for women with bioprostheses than for those with mechanical prostheses. However, bioprostheses are associated with a high reoperation rate in young women and it remains unclear whether these young women can give birth without any complications. We analyzed the outcomes of prosthetic valve replacement and investigated the effectiveness and problems associated with bioprostheses in women of child-bearing age in Japan. Methods The subjects of this study were six consecutive young adult women aged under 40 years, who underwent prosthetic valve replacement between January 2007 and April 2016. Results Bioprostheses were selected for four of these six women in consideration of their child-bearing age. Mechanical valves were selected for the other two women who underwent the Konno procedure and double valve replacement (AVR, MVR) in view of their high risk for reoperation. The cardiac operations, although without mortality or morbidity, were complex and some involved multi-time procedures. Three of the women with bioprostheses had uneventful term pregnancies. Conclusions These young women with bioprostheses were able to give birth safely; however, as multiple operations are often required, and bioprostheses may not be ideal for young women. Prosthetic valve selection for young women of child-bearing age requires adequate pregnancy counseling and long-term planning.