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Ann Thorac Surg 1994;58:1168-1170
© 1994 The Society of Thoracic Surgeons

Articles

Home heparin therapy used in a pregnant patient with a mechanical heart valve prosthesis

Victor A. Ferraris, MD, PhD*, Robert R. Klingman, MD, Linda Dunn, RN, Steven Fein, MD, Marla Eglowstein, MD, Renee Samelson, MD

Divisions of Cardiothoracic Surgery, Cardiology, and Perinatology, Albany Medical College, Albany, New York, USA

Accepted for publication January 25, 1994.

* Address reprint requests to Dr Ferraris, Division of Cardiothoracic Surgery, Albany Medical College, Suite A330/A-61, Albany, NY 12208.

The optimal anticoagulation therapy for pregnant patients with a mechanical valve prosthesis is uncertain, but teratogenic effects and the high incidence of fetal loss associated with dicumarol derivatives limit the use of these agents as anticoagulants in this setting. A patient with a mechanical valve prosthesis, in the first trimester of pregnancy, stopped taking her warfarin because of personal fears about teratogenicity. Prosthetic valve thrombosis developed, and she required redo mitral valve replacement. Another mechanical prosthesis was inserted without maternal or fetal injury. The patient was maintained on continuous home, intravenous, high-dose heparin therapy for the remainder of her pregnancy. This therapy resulted in a successful pregnancy and delivery without valve thrombosis, hemorrhagic events, or maternal or fetal compromise.




This article has been cited by other articles:


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 Arch Intern MedHome page
W. S. Chan, S. Anand, and J. S. Ginsberg
Anticoagulation of Pregnant Women With Mechanical Heart Valves: A Systematic Review of the Literature
Arch Intern Med, January 24, 2000; 160(2): 191 - 196.
[Abstract] [Full Text] [PDF]


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