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Patient-prosthesis mismatch in pregnancy
Robert C Johnston1, Morgan L Swank, Vineet K Shrivastava
1Department of Obstetrics & Gynecology, University of California Irvine Medical Center, Orange, and Miller Children's Hospital-Long Beach Memorial Medical Center, Long Beach, California.
Background:
Patient-prosthesis mismatch is a known and severe complication after aortic valve repair in the general population. There is a paucity of literature regarding this condition in pregnancy.
Case:
We present the clinical course of a pregnant woman with severe patient-prosthesis mismatch after aortic valve replacement. After extensive workup, the patient underwent aortic valve replacement, enlargement of the aortic root, and placement of a larger prosthetic valve at 21 weeks of gestation. Her postoperative course was complicated by fetal death.
Conclusion:
Cardiopulmonary bypass and aortic valve replacement present a multitude of risks to maternal and fetal health. The obstetrician managing pregnant women with prosthetic heart valves should be aware of the complications that may arise, including patient-prosthesis mismatch.
