[The porcine valve prosthesis and pregnancy]

Area of Science:

• Cardiovascular Surgery
• Obstetrics
• Biomaterials Science

Context:

• Pregnancy in women with mechanical prosthetic valves presents significant risks, primarily due to the necessity of anticoagulation.
• Mechanical valves require anticoagulation, which poses a high risk of bleeding and thrombosis during pregnancy.
• Previous research has focused on identifying non-thrombogenic valve alternatives for this patient population.

Purpose:

• To evaluate the safety and efficacy of biological porcine prosthetic valves in pregnant women.
• To assess the incidence of valve dysfunction, calcification, and related complications during pregnancy.
• To determine the obstetric outcomes and fetal well-being in pregnancies with biological porcine valves.

Summary:

• A study followed 11 patients with biological porcine prosthetic valves through 14 pregnancies, assessing outcomes with regular clinical and echocardiographic monitoring.
• Six patients experienced heart failure (NYHA Class I-IV), and four valves showed dysfunction/calcification during pregnancy.
• Pregnancies resulted in 7 normal deliveries and 4 cesarean sections; no fetal distress was observed, and clinical management of valve dysfunction was successful without anticoagulation.

Impact:

• Biological porcine valves provide hemodynamic stabilization during pregnancy, allowing clinical management of dysfunction without anticoagulation.
• These valves are indicated for women desiring pregnancy post-valve replacement, mitigating risks associated with mechanical valves.
• The findings suggest biological valves are a safer option, improving maternal and fetal outcomes in this high-risk group.