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Pumping for Two: Pregnancy in Patients Supported With a Left Ventricular Assist Device
Daniel Oren1, Cathrine M Moeller1, Jennifer H Haythe1
1From the Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 7, 2023
Summary
Pregnancy with a left ventricular assist device (LVAD) is possible, though risky. Successful births occurred in 80% of reviewed cases, emphasizing multidisciplinary care for managing risks during pregnancy.
Area of Science:
- Cardiology
- Reproductive Medicine
- Critical Care Medicine
Background:
- Left ventricular assist devices (LVADs) are crucial for advanced heart failure.
- Women comprise a significant portion of heart failure patients.
- Pregnancy in LVAD patients presents unique maternal and fetal risks.
Purpose of the Study:
- To review the challenges and outcomes of pregnancy in women with LVAD support.
- To identify critical management strategies for successful pregnancies.
- To inform shared decision-making for LVAD patients considering pregnancy.
Main Methods:
- Literature review of confirmed pregnancies in women with LVAD support.
- Analysis of maternal and fetal outcomes.
- Synthesis of management strategies for hemodynamic stability and safety.
Main Results:
- Ten cases of pregnancy during LVAD support were identified.
- Eight successful births were reported.
- Risks include hemodynamic stress, thrombosis, teratogenicity, and uterine impingement.
Conclusions:
- Pregnancy with LVAD support is achievable with careful management.
- A multidisciplinary approach, optimized anticoagulation, and LVAD adjustments are vital.
- Further research is needed to support informed patient choices.
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