Mechanical aortic valve replacement in young women planning on pregnancy: Maternal and fetal outcomes under low oral anticoagulation, a pilot observational study on a comprehensive pre-operative counseling protocol

Journal of the American College of Cardiology

Volumn 59, Issue 12, 2012, Pages 1110-1115

  De Santo, Luca S ^a   Romano, Gianpaolo ^a   Della Corte, Alessandro ^a   D'Oria, Veronica ^a   Nappi, Gianantonio ^a   Giordano, Salvatore ^b   Cotrufo, Maurizio ^b   De Feo, Marisa ^a  

^a MONALDI HOSPITAL   (Italy)

^b Pineta Grande Hospital   (Italy)

Author keywords

low dose oral anticoagulation; pregnancy; prosthetic heart valves

Indexed keywords

HEPARIN; LOW MOLECULAR WEIGHT HEPARIN; WARFARIN;

ADULT; ANTICOAGULANT THERAPY; AORTA VALVE PROSTHESIS; AORTA VALVE REPLACEMENT; ARTICLE; BIRTH DEFECT; BLEEDING; CLINICAL ARTICLE; CLINICAL PROTOCOL; FEMALE; HUMAN; INTERNATIONAL NORMALIZED RATIO; LOW DRUG DOSE; MECHANICAL AORTA VALVE REPLACEMENT; OBSERVATIONAL STUDY; PATIENT COUNSELING; PATIENT PREFERENCE; PATIENT REFERRAL; PRACTICE GUIDELINE; PREGNANCY; PREGNANCY OUTCOME; PRENATAL DISORDER; PREOPERATIVE CARE; PRIORITY JOURNAL; PROSPECTIVE STUDY; SAFETY; SPONTANEOUS ABORTION; STILLBIRTH; THROMBOSIS;

ADMINISTRATION, ORAL; ADULT; ALGORITHMS; ANTICOAGULANTS; AORTIC VALVE; BIOPROSTHESIS; CONFOUNDING FACTORS (EPIDEMIOLOGY); COUNSELING; DRUG ADMINISTRATION SCHEDULE; FEMALE; GESTATIONAL AGE; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; HEPARIN, LOW-MOLECULAR-WEIGHT; HUMANS; INTERNATIONAL NORMALIZED RATIO; MITRAL VALVE; PILOT PROJECTS; PREGNANCY; PREGNANCY COMPLICATIONS, CARDIOVASCULAR; PREGNANCY OUTCOME; PREGNANCY TRIMESTERS; PREOPERATIVE PERIOD; PROSPECTIVE STUDIES; REOPERATION; THROMBOSIS; TREATMENT OUTCOME; WARFARIN;

EID: 84858231144     PISSN: 07351097     EISSN: 15583597     Source Type: Journal    
DOI: 10.1016/j.jacc.2011.10.899     Document Type: Article

References (27)

1. U. Elkayam, F. Bitar Valvular heart disease and pregnancy Part I: native valves J Am Coll Cardiol 46 2005 223 230 (Pubitemid 40966847)
2. P.G. Pieper, A. Balci, A.P. Van Dijk Pregnancy in women with prosthetic heart valves Neth Heart J 16 2008 406 411
3. U. Elkayam, F. Bitar Valvular heart disease and pregnancy Part II: prosthetic valves J Am Coll Cardiol 46 2005 403 410 (Pubitemid 41040278)
4. L. Hung, S.H. Rahimtoola Prosthetic heart valves and pregnancy Circulation 107 2003 1240 1246 (Pubitemid 36314404)
5. N. Vitale, M. De Feo, L.S. De Santo, A. Pollice, N. Tedesco, M. Cotrufo Dose dependent fetal complications of warfarin in pregnant women with mechanical heart valves J Am Coll Cardiol 33 1999 1637 1641
6. A. Shlebak, I. Malik Managing heparin anticoagulation in patients with prosthetic cardiac valves: balancing the risk Heart 95 2009 1643 1645
7. P. Herijgers, P. Verhamme Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for? Eur Heart J 28 2007 2424 2426 (Pubitemid 47614294)
8. M. Torella, D. Torella, P. Chiodini Lowering the Intensity of Oral Anticoagulant Therapy in Patients With Bileaflet Mechanical Aortic Valve Replacement: results from the LOWERING-IT trial Am Heart J 160 2010 171 178
9. M. Cotrufo, T.S. de Luca, R. Calabr, G. Mastrogiovanni, D. Lama Coumarin anticoagulation during pregnancy in patients with mechanical valve prostheses Eur J Cardiothorac Surg 5 1991 300 304
10. G. Hanania Management of anticoagulants during pregnancy Heart 86 2001 125 126 (Pubitemid 32983467)
11. R.O. Bonow, B.A. Carabello, K. Chatterjee ACC/AHA 2006 guidelines for the management of patients with valvular heart disease Executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines J Am Coll Cardiol 48 2006 598 675
12. A. Vahanian, H. Baumgartner, J. Bax Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology Eur Heart J 28 2007 230 268 (Pubitemid 46276943)
13. M.S. Shannon, M.B. Edwards, F. Long, K.M. Taylor, J.P. Bagger, M. De Swiet Anticoagulant management of pregnancy following heart valve replacement in the United Kingdom, 19862002 J Heart Valve Dis 17 2008 526 532
14. A.H. James, L.R. Brancazio, T.R. Gehrig, A. Wang, T.L. Ortel Low-molecular-weight heparin for thromboprophylaxis in pregnant women with mechanical heart valves J Matern Fetal Neonatal Med 19 2006 543 549 (Pubitemid 44373606)
15. Y. Yinon, S.C. Siu, C. Warshafsky Use of low molecular weight heparin in pregnant women with mechanical heart valves Am J Cardiol 104 2009 1259 1263
16. C. McLintock, L. McCowan, R. North Maternal complications and pregnancy outcome in women with mechanical prosthetic heart valves treated with enoxaparin BJOG Int J Obstet Gynaecol 116 2009 1585 1592
17. E. Friedrich, A.B. Hameed Fluctuations in anti-factor Xa levels with therapeutic enoxaparin anticoagulation in pregnancy J Perinatol 30 2010 253 257
18. L.A. Barbour, J.L. Oja, L.K. Schultz A prospective trial that demonstrates that dalteparin requirements increase in pregnancy to maintain therapeutic levels of anticoagulation Am J Obstet Gynecol 191 2004 1024 1029 (Pubitemid 39298153)
19. J.N. Saour, J.O. Sieck, L.A. Mamo, A.S. Gallus Trial of different intensities of anticoagulation in patients with prosthetic heart valves N Engl J Med 322 1990 428 432 (Pubitemid 20059511)
20. D. Hering, C. Piper, R. Bergemann Thromboembolic and bleeding complications following St. Jude Medical valve replacement: results of the German experience with low-intensity anticoagulation study Chest 127 2005 53 59 (Pubitemid 41724555)
21. H. Koertke, A. Zittermann, G. Tenderich Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II Eur Heart J 28 2007 2479 2484 (Pubitemid 47614293)
22. H. Koertke, A. Zittermann, O. Wagner Efficacy and safety of very low dose self-management of oral anticoagulation in patients with mechanical heart valve replacement Ann Thorac Surg 90 2010 1487 1493
23. L. Dong, Y. Shi, Z. Tian The follow up of 12 pregnant women with anticoagulation therapy after mechanical heart valve replacement Zhonghua Fu Chan Ke Za Zhi 36 2001 465 467
24. M.A. Geelani, S. Singh, A. Verma, A. Nagesh, V. Betigeri, M. Nigam Anticoagulation in patients with mechanical valves during pregnancy Asian Cardiovasc Thorac Ann 13 2005 30 33 (Pubitemid 40613202)
25. L. Sadler, L. McCowan, H. White, A. Stewart, M. Bracken, R. North Pregnancy outcomes and cardiac complications in women with mechanical, bioprosthetic and homograft valves BJOG Int J Obstet Gynaecol 107 2000 245 253 (Pubitemid 30081591)
26. J.L. Ecker, F.D. Frigoletto Jr Cesarean delivery and the risk-benefit calculus N Engl J Med 356 2007 885 888 (Pubitemid 46339905)
27. L.J. Muglia, M. Katz The enigma of spontaneous preterm birth N Engl J Med 362 2010 529 535