Cardoso Gonçalo, Aguiar Carlos, Andrade Maria João, Patrício Lino, Freire Isabel, Serrano Fátima, Anjos Rui, Mendes Miguel
Department of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, Portugal.
Department of Cardiology, Santa Cruz Hospital, CHLO, Carnaxide, Portugal.
Rev Port Cardiol. 2015 Jan;34(1):71.e1-5. doi: 10.1016/j.repc.2014.09.007. Epub 2015 Jan 8.
Pregnant women with mechanical prosthetic heart valves are at increased risk for valve thrombosis. Management decisions for this life-threatening complication are complex. Open-heart surgery has a very high risk of maternal mortality and fetal loss. Bleeding and embolic risks associated with thrombolytic agents, the limited efficacy of thrombolysis in certain subgroups, and a lack of experience in the setting of pregnancy raise important concerns.
We report a case of mitral prosthetic valve thrombosis in early pregnancy, which was successfully treated with streptokinase. Ten years later, the same patient had an uneventful pregnancy, throughout which acenocoumarol was maintained.
With this case we review the prevention (with oral anticoagulant therapy) and treatment of prosthetic valve thrombosis during pregnancy, which is important for both obstetrician and cardiologist.
患有机械人工心脏瓣膜的孕妇发生瓣膜血栓形成的风险增加。对于这种危及生命的并发症的管理决策很复杂。心脏直视手术有很高的孕产妇死亡率和胎儿丢失风险。与溶栓药物相关的出血和栓塞风险、某些亚组中溶栓效果有限以及在妊娠情况下缺乏经验引发了重要问题。
我们报告一例妊娠早期二尖瓣人工瓣膜血栓形成病例，该病例成功接受链激酶治疗。十年后，同一患者妊娠过程顺利，整个孕期维持使用醋硝香豆素。
通过该病例，我们回顾了孕期人工瓣膜血栓形成的预防（采用口服抗凝治疗）和治疗，这对产科医生和心脏病专家都很重要。
