Emergent surgical treatment of lethal valve dysfunction during pregnancy in a last-trimester patient

• Published in: Saudi medical journal 2018-12, Vol.39 (12), p.1249-1252
• Main Authors: Akbayrak, Hakan, Çiçek, Ömer F, Orhan, Atilla
• Format: Article
• Language: English
• Subjects: Anticoagulants; Anticoagulants - therapeutic use; Care and treatment; Case Report; Case reports; Cesarean Section; Device Removal - methods; Dyspnea; Echocardiography; Embolisms; Emergency medical care; Female; Fetuses; Health aspects; Heart rate; Heart Septal Defects, Atrial - surgery; Heart surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - methods; Humans; Medication Adherence; Mitral Valve - surgery; Mitral Valve Insufficiency - surgery; Mortality; Patients; Pregnancy; Pregnancy Complications, Cardiovascular - surgery; Pregnancy Trimester, Third; Prostheses; Thrombosis; Thrombosis - surgery; Young Adult
• ISSN: 0379-5284; 1658-3175
• DOI: 10.15537/smj.2018.12.22925

A mechanical heart valve thrombosis during pregnancy is one of the most lethal conditions to experience due to its detrimental effects on both mother and fetus. Cardiac surgery during pregnancy is reserved for cases where medical treatment fails due to harmful maternal and fetal effects. A 24-year-old female in the 38th week of pregnancy was admitted to the emergency room with aggravated dyspnea, tachypnea, and palpitations. She had 2 previous cardiac operations in her medical history. A stuck mechanical valve was diagnosed in the mitral position via transthoracic echocardiography, which had resulted from her decision to cease taking warfarin when planning to become pregnant. In pregnant patients who have prosthetic mechanical valve thrombosis, surgical approach should be considered depending on the conditions of the mother and the baby. When emergency delivery of the baby is feasible, emergent surgical treatment should be utilized for patients who are in critical condition.