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J Am Coll Cardiol, 2005; 46:403-410, doi:10.1016/j.jacc.2005.02.087 (Published online 14 July 2005).
© 2005 by the American College of Cardiology Foundation
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STATE-OF-THE-ART PAPER

Valvular Heart Disease and Pregnancy

Part II: Prosthetic Valves

Uri Elkayam, MD, FACC* and Fahed Bitar, MD

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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