Anticoagulation for prosthetic heart valves during pregnancy: is low-molecular-weight heparin an alternative?
We report on the treatment failure of low molecular weight heparin (LMWH) for anticoagulation in a pregnant woman that underwent artificial mitral valve replacement 10 years prior to her pregnancy. Until she became pregnant warfarin was administered for anticoagulation, but due to the often mentione...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2002-03, Vol.21 (3), p.577-579 |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Leyh, Rainer G. Fischer, Stefan Ruhparwar, Arjang Haverich, Axel |
| description | We report on the treatment failure of low molecular weight heparin (LMWH) for anticoagulation in a pregnant woman that underwent artificial mitral valve replacement 10 years prior to her pregnancy. Until she became pregnant warfarin was administered for anticoagulation, but due to the often mentioned increased risk for warfarin-induced maternal and fetal complications, at gestational week 5 the anticoagulation regimen was switched to subcutaneous application of low molecular weight heparin. At gestational week 24 our patient developed acute life-threatening pulmonary edema and hemodynamic instability due to acute mitral valve thrombosis and underwent emergency valve re-replacement with a biological porcine valve. She recovered uneventfully and gave birth to a healthy child at gestational week 35. In addition to our case presentation we review the sparse evidence in the literature regarding anticoagulation in pregnant women with mechanical heart valves and discuss the rational of different anticoagulation regimens with regards to maternal and fetal outcome. Special consideration is directed towards LMWH administration as an alternative to oral anticoagulation during pregnancy in women with mechanical heart valves. |
| doi_str_mv | 10.1016/S1010-7940(01)01154-X |
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Until she became pregnant warfarin was administered for anticoagulation, but due to the often mentioned increased risk for warfarin-induced maternal and fetal complications, at gestational week 5 the anticoagulation regimen was switched to subcutaneous application of low molecular weight heparin. At gestational week 24 our patient developed acute life-threatening pulmonary edema and hemodynamic instability due to acute mitral valve thrombosis and underwent emergency valve re-replacement with a biological porcine valve. She recovered uneventfully and gave birth to a healthy child at gestational week 35. In addition to our case presentation we review the sparse evidence in the literature regarding anticoagulation in pregnant women with mechanical heart valves and discuss the rational of different anticoagulation regimens with regards to maternal and fetal outcome. Special consideration is directed towards LMWH administration as an alternative to oral anticoagulation during pregnancy in women with mechanical heart valves.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/S1010-7940(01)01154-X</identifier><identifier>PMID: 11888791</identifier><identifier>CODEN: EJCSE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Science B.V</publisher><subject>Adult ; Anticoagulants - therapeutic use ; Anticoagulation ; Biological and medical sciences ; Female ; Heart Valve Prosthesis ; Heparin, Low-Molecular-Weight - therapeutic use ; Humans ; Low molecular weight heparin ; Medical sciences ; Mitral Valve ; Pregnancy ; Pregnancy Complications, Hematologic - drug therapy ; Pregnancy Complications, Hematologic - surgery ; Prosthetic heart valves ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Thrombosis - drug therapy ; Thrombosis - surgery ; Warfarin - therapeutic use</subject><ispartof>European journal of cardio-thoracic surgery, 2002-03, Vol.21 (3), p.577-579</ispartof><rights>Elsevier Science B.V. © 2002 Elsevier Science B.V. All rights reserved. 2002</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c496t-5bc5d5368878a702ff54576d0e604fe2dd417d5f6cff709bc7db6192828032263</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13539692$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11888791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leyh, Rainer G.</creatorcontrib><creatorcontrib>Fischer, Stefan</creatorcontrib><creatorcontrib>Ruhparwar, Arjang</creatorcontrib><creatorcontrib>Haverich, Axel</creatorcontrib><title>Anticoagulation for prosthetic heart valves during pregnancy: is low-molecular-weight heparin an alternative?</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><addtitle>Eur J Cardiothorac Surg</addtitle><description>We report on the treatment failure of low molecular weight heparin (LMWH) for anticoagulation in a pregnant woman that underwent artificial mitral valve replacement 10 years prior to her pregnancy. Until she became pregnant warfarin was administered for anticoagulation, but due to the often mentioned increased risk for warfarin-induced maternal and fetal complications, at gestational week 5 the anticoagulation regimen was switched to subcutaneous application of low molecular weight heparin. At gestational week 24 our patient developed acute life-threatening pulmonary edema and hemodynamic instability due to acute mitral valve thrombosis and underwent emergency valve re-replacement with a biological porcine valve. She recovered uneventfully and gave birth to a healthy child at gestational week 35. In addition to our case presentation we review the sparse evidence in the literature regarding anticoagulation in pregnant women with mechanical heart valves and discuss the rational of different anticoagulation regimens with regards to maternal and fetal outcome. Special consideration is directed towards LMWH administration as an alternative to oral anticoagulation during pregnancy in women with mechanical heart valves.</description><subject>Adult</subject><subject>Anticoagulants - therapeutic use</subject><subject>Anticoagulation</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Heart Valve Prosthesis</subject><subject>Heparin, Low-Molecular-Weight - therapeutic use</subject><subject>Humans</subject><subject>Low molecular weight heparin</subject><subject>Medical sciences</subject><subject>Mitral Valve</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Hematologic - drug therapy</subject><subject>Pregnancy Complications, Hematologic - surgery</subject><subject>Prosthetic heart valves</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Thrombosis - drug therapy</subject><subject>Thrombosis - surgery</subject><subject>Warfarin - therapeutic use</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkF1rFDEUhoNYbK3-BGVuLHoRPfme8aaUUt1KwYtWWLwJ2UyyG52PNcls239vtrtaBCEkB87znjfnRegVgfcEiPxwXW7AquHwFsg7IERwPH-CjkitGFaMz5-W-g9yiJ6n9AMAJKPqGTokpK5r1ZAj1J8NOdjRLKfO5DAOlR9jtY5jyitXGtXKmZirjek2LlXtFMOwLG23HMxg7z9WIVXdeIv7sXO2TIj41oXlKhfZ2hS2MuV02cWhDN-40xfowJsuuZf79xh9-3Rxcz7DV18_X56fXWHLG5mxWFjRCibLH2ujgHovuFCyBSeBe0fblhPVCi-t9wqahVXtQpKG1rQGRqlkx-hkN7ds8mtyKes-JOu6zgxunJJWRBAKwAsodqAtK6fovF7H0Jt4rwnobc76IWe9DVED0Q8563nRvd4bTIvetY-qfbAFeLMHTLKm87HkFdIjxwRrZEMLBztunNb_98b_eOOtN95JQsru7q_IxJ9aKqaEns2_62vO5eyGftGM_QYGdaRI</recordid><startdate>20020301</startdate><enddate>20020301</enddate><creator>Leyh, Rainer G.</creator><creator>Fischer, Stefan</creator><creator>Ruhparwar, Arjang</creator><creator>Haverich, Axel</creator><general>Elsevier Science B.V</general><general>Elsevier Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020301</creationdate><title>Anticoagulation for prosthetic heart valves during pregnancy: is low-molecular-weight heparin an alternative?</title><author>Leyh, Rainer G. ; Fischer, Stefan ; Ruhparwar, Arjang ; Haverich, Axel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c496t-5bc5d5368878a702ff54576d0e604fe2dd417d5f6cff709bc7db6192828032263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Anticoagulants - therapeutic use</topic><topic>Anticoagulation</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Heart Valve Prosthesis</topic><topic>Heparin, Low-Molecular-Weight - therapeutic use</topic><topic>Humans</topic><topic>Low molecular weight heparin</topic><topic>Medical sciences</topic><topic>Mitral Valve</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Hematologic - drug therapy</topic><topic>Pregnancy Complications, Hematologic - surgery</topic><topic>Prosthetic heart valves</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Thrombosis - drug therapy</topic><topic>Thrombosis - surgery</topic><topic>Warfarin - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leyh, Rainer G.</creatorcontrib><creatorcontrib>Fischer, Stefan</creatorcontrib><creatorcontrib>Ruhparwar, Arjang</creatorcontrib><creatorcontrib>Haverich, Axel</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leyh, Rainer G.</au><au>Fischer, Stefan</au><au>Ruhparwar, Arjang</au><au>Haverich, Axel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anticoagulation for prosthetic heart valves during pregnancy: is low-molecular-weight heparin an alternative?</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><stitle>Eur J Cardiothorac Surg</stitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2002-03-01</date><risdate>2002</risdate><volume>21</volume><issue>3</issue><spage>577</spage><epage>579</epage><pages>577-579</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><coden>EJCSE7</coden><abstract>We report on the treatment failure of low molecular weight heparin (LMWH) for anticoagulation in a pregnant woman that underwent artificial mitral valve replacement 10 years prior to her pregnancy. Until she became pregnant warfarin was administered for anticoagulation, but due to the often mentioned increased risk for warfarin-induced maternal and fetal complications, at gestational week 5 the anticoagulation regimen was switched to subcutaneous application of low molecular weight heparin. At gestational week 24 our patient developed acute life-threatening pulmonary edema and hemodynamic instability due to acute mitral valve thrombosis and underwent emergency valve re-replacement with a biological porcine valve. She recovered uneventfully and gave birth to a healthy child at gestational week 35. In addition to our case presentation we review the sparse evidence in the literature regarding anticoagulation in pregnant women with mechanical heart valves and discuss the rational of different anticoagulation regimens with regards to maternal and fetal outcome. Special consideration is directed towards LMWH administration as an alternative to oral anticoagulation during pregnancy in women with mechanical heart valves.</abstract><cop>Amsterdam</cop><pub>Elsevier Science B.V</pub><pmid>11888791</pmid><doi>10.1016/S1010-7940(01)01154-X</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult Anticoagulants - therapeutic use Anticoagulation Biological and medical sciences Female Heart Valve Prosthesis Heparin, Low-Molecular-Weight - therapeutic use Humans Low molecular weight heparin Medical sciences Mitral Valve Pregnancy Pregnancy Complications, Hematologic - drug therapy Pregnancy Complications, Hematologic - surgery Prosthetic heart valves Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Thrombosis - drug therapy Thrombosis - surgery Warfarin - therapeutic use |
| title | Anticoagulation for prosthetic heart valves during pregnancy: is low-molecular-weight heparin an alternative? |
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