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You are here: Contents > 2013 > Volume 22 Number 4 July 2013 > CASE REPORT > Mechanical Heart Valve Thrombosis in Pregnancy

Mechanical Heart Valve Thrombosis in Pregnancy

Shmuel Schwartzenberg1, Sharon Perlman2, Rony Levy2, Uri Elkayam3, Sorel Goland1

1The Heart Institute and Department of Obstetrics and 2Gynecology, Kaplan Medical Center, Rehovot, Affiliated to the Hebrew University and Hadassah Medical School, Jerusalem, Israel, 3The Department of Medicine, Division of Cardiovascular Medicine, University of Southern California, Keck school of Medicine, Los Angeles, California, USA

Effective anticoagulation is critical in patients with mechanical prosthetic heart valve (MPHV), but remains challenging in pregnancy because both oral anticoagulation and heparins are associated with important fetal and maternal risks. A 33-year-old high-risk pregnant woman presented with MPHV thrombosis during early pregnancy. Resolution of the thrombus and eventual resumption of normal prosthetic mitral valve function was obtained

through treatment with low-molecular weight heparin (LMWH). This case of early pregnancy MPHV thrombosis emphasized the importance of adequate initial coagulation prior to pregnancy and the potential need to extend measurements to both peak and trough levels to assure an adequate level of anticoagulation in women with MPHV treated with LMWH during pregnancy.

The Journal of Heart Valve Disease 2013;22:603-606

Mechanical Heart Valve Thrombosis in Pregnancy

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