Pregnancy and valvular heart disease

Česká verzia

Authors: Linhartová K.
Authors place of work: Kardiochirurgické oddělení, Komplexní kardiovaskulární centrum, FN Plzeň
Published in the journal: Kardiol Rev Int Med 2018, 20(4): 269-272

Summary

Valvular heart disease in pregnancy is an important cause of morbidity and mortality. Preconception counselling is an important part of follow-up in women with valve disease. Multidisciplinary team cooperation is important during pregnancy and labour. In general, mild valvular disease is well tolerated, and regurgitant lesions are better tolerated than stenotic ones. Pregnancy in women with mechanical valve prosthesis is a specific situation with a high frequency of complications associated with anticoagulant treatment. Echocardiography is the basic examination method. Pregnancy is considered contraindicated in severe symptomatic valve disease or severe asymptomatic valve disease with low ejection fraction of the left ventricle and correction of such valve disease is recommended before pregnancy. In moderate to severe asymptomatic disease, assessment of the functional capacity by a stress test is recommended before or at the start of pregnancy. The frequency of follow-up should be monthly or bimonthly in moderate to severe cases. Preconception counselling is an important part of follow-up in patients with valve disease. Treatment, if necessary, is bed rest regime and diuretic or arrhythmia treatment, but catheter or even surgical treatment at specialised centres is considered in refractory cases.

Key words:

pregnancy – bicuspid aortic valve – aortic stenosis – aortic regurgitation – mitral regurgitation – mitral stenosis.

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