[The porcine valve prosthesis and pregnancy].

Anticoagulation is the chief problem during pregnancy of women with mechanical prosthetic valves. Many studies have investigated a nonthrombogenic valve. Since 1978 we have used a biological porcine prosthetic valves in 16 pregnancies, 11 patients with regular clinical electrocardiographic, echocardiographic and chest roentgenographic follow-up. The patients' ages were 19 to 32 years during pregnancy. Nine had mitral, one aortic and one mitro-aortic prosthesis. Two patients dropped out during the study so we completed it with 14 pregnancies. Six patients coursed with grade I heart failure (HYHA), five grade II and three grade IV. All of them were treated clinically. Four valves had dysfunction and calcification during pregnancy and two before pregnancy. The pregnancies resulted in three abortions, seven normal deliveries and four caesarean section with obstetric indication. Fetal distress was not observed during or after delivery. The physiopathology of valve dysfunction during pregnancy was discussed and it was concluded that the biologic porcine prosthetic valve allows hemodynamic stabilization. If dysfunction appears it may be clinically controlled without need of anticoagulation, risk of calcification nor dysfunction during pregnancy. The biologic valves are best indicated for women who wish to become pregnant after valve substitution.