Pregnancy after valve replacement with porcine xenograft prosthesis

The course of 22 pregnancies in 11 women undergoing heart valve replacement with a porcine xenograft is reported. All of the pregnancies treated with warfarin were interrupted by induced abortion. Of the 11 pregnancies treated with dipyridamole which were not interrupted by induced abortion, fetal wastage occurred in five. There was no fetal wastage among three patients who were not treated by any kind of anticoagulant. A review of the literature revealed that fetal complications among patients with the mechanical prosthetic valve are significantly higher compared with patients with bioprosthetic valves. There was no maternal hemorrhagic or thromboembolic event in patients with bioprosthetic valves. Delivery after porcine xenograft insertion is safe provided that the patient is in good cardiac condition and does not require warfarin treatment.