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STATE-OF-THE-ART PAPER

Valvular Heart Disease and Pregnancy

Part II: Prosthetic Valves

Heart Failure Program, Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California.

Manuscript received January 28, 2005; accepted February 8, 2005.

^_* Reprint requests and correspondence: Dr. Uri Elkayam, Heart Failure Program, Keck School of Medicine, Los Angeles County/University of Southern California Medical Center, Room 7621, 1200 North State Street, Los Angeles, California 90033. (Email: elkayam{at}usc.edu).

A large number of prosthetic heart valves (PHV) are being implanted in patients with both congenital and acquired valvular disease. Many of the recipients of such valves are women of childbearing age who desire to have children. The main issues involved with pregnancy in a patient with PHV include the selection of PHV in women during their childbearing age, risks to both the mother and the fetus associated with pregnancy and the management of the patients with PHV during gestation.

Abbreviations and Acronyms   ACCP = American College of Chest Physicians   aPTT = activated partial thromboplastin time   LMWH = low molecular weight heparin   PHV = prosthetic heart valve   SVD = structural valve deterioration   UFH = unfractionated heparin

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