A case of prosthesis-patient mismatch complicating pregnancy

Prosthesis-patient mismatch occurs when the effective prosthetic valve area is smaller than that of a normal human valve. Its importance in pregnancy is unknown. We describe an asymptomatic patient with higher than normal transvalvular gradients due to prosthesis-patient mismatch who developed congestive heart failure in late pregnancy. Our recommendation is that pregnant patients, particularly those with a small valve prosthesis, undergo serial echocardiography because these patients are at high risk of developing heart failure.