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Apr 24, 2012

Mechanical Aortic Valve Replacement Before Pregnancy

Surgery and blood thinners may help women with aortic valve disease have safe pregnancy and delivery.

Aortic valve disease occurs when the aortic valve, which opens and closes to help pump blood through the heart, malfunctions. Most often, valve disease is congenital (present at birth) and is due to either narrowing or leaking in the aortic valve. Although serious, this condition can be treated, often later in life, through surgery in which the faulty valve is either repaired or replaced. However, having aortic valve surgery often requires lifelong use of anticoagulants (blood thinners) that prevent blood clots from forming after surgery.

Although aortic valve repair and replacement is often a safe and effective option for many, experts are less clear on the safety of this surgery for women planning on pregnancy in the future. Could the surgery and lifelong use of anticoagulation therapy have a negative effect on the mother or baby's health?

Fortunately, a study published in the Journal of the American College of Cardiology suggests that low-dose anticoagulation therapy is safe for both mother and fetus. In this study, involving 40 individuals with valve disease, doctors counseled patients on the risks and benefits of valve replacement, based on a protocol developed for the study. After receiving counseling, 22 of the 40 female patients went on to have valve replacement surgery. Sixteen of the patients became pregnant following their procedure. Researchers followed these women throughout their pregnancy, and they observed no complications from the low-dose anticoagulation therapy.

Although further studies are needed to validate the safety of blood thinners in pregnant women, findings are promising. Many individuals choose aortic valve replacement to help them maintain an active, normal lifestyle. For many women this includes pregnancy. And while the lifelong reliance on anticoagulants has been a concern for women planning on pregnancy, this may no longer prove to be an issue, giving women with aortic valve disease more treatment options earlier in life.

Read this Article in the Journal of the American College of Cardiology.

Questions for You to Consider

  • What is anticoagulation therapy?

  • Anticoagulant medications are blood thinners that help prevent blood clots from forming around the replacement valve, which can cause heart attack and stroke. Examples of such drugs include warfarin, heparin and aspirin.
  • Why are patients receiving valve replacement reliant on blood thinners?

  • Most valve replacement patients need to be on lifelong anticoagulation therapy because their surgery puts them at increased risk for blood clots. The body is more likely to create blood clots on or around a foreign object like a replacement valve. If a blood clot forms, breaks off and travels to the heart, it can get stuck in a vein or artery and block the flow of blood, causing a heart attack or stroke. Therefore, taking blood thinners helps prevent the formation of blood clots and decreases risk for heart attack and stroke.

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