Department of Internal Medicine, Marshfield Medical Center-Marshfield, Marshfield, Wisconsin.
Clinical Research Center, Marshfield Clinic Research Institute, Marshfield, Wisconsin.
Catheter Cardiovasc Interv. 2020 May 1;95(6):1225-1229. doi: 10.1002/ccd.28481. Epub 2019 Sep 4.
Symptomatic degenerative prosthetic aortic valve stenosis during pregnancy represents a significant risk to both mother and fetus, and until recently, surgical aortic valve replacement (SAVR) during pregnancy was often the only choice for women opting to continue pregnancy. However, symptomatic severe stenosis in a pregnant woman with a degenerated full aortic root Freestyle stentless bioprosthesis (FSB) and reimplanted coronary arteries presents additional complexities that require an alternative surgical approach. In this case report, we describe the first successful transcatheter aortic valve replacement (TAVR) in SAVR for a severely stenotic degenerative FSB in a pregnant woman and subsequent delivery of a healthy infant several months later. TAVR in SAVR of a severely stenotic aortic FSB should be considered as a surgical option in symptomatic pregnant women. Short-term and long-term implications for future pregnancy should be discussed by a multidisciplinary team and with the patient.
妊娠期间症状性退行性人工主动脉瓣狭窄对母亲和胎儿都构成重大风险，直到最近，妊娠期间进行主动脉瓣置换术（SAVR）通常是选择继续妊娠的女性的唯一选择。然而，对于患有退行性全主动脉根部 Freedom 无支架生物瓣（FSB）和再植冠状动脉的症状性重度狭窄的孕妇，会出现其他复杂性问题，需要采用替代手术方法。在本病例报告中，我们描述了首例成功的经导管主动脉瓣置换术（TAVR），用于 SAVR 治疗症状性退行性重度狭窄的 FSB 孕妇，并在数月后成功分娩健康婴儿。对于症状性妊娠女性，应考虑将严重狭窄的主动脉瓣 FSB 的 SAVR 中的 TAVR 作为一种手术选择。应通过多学科团队并与患者一起讨论对未来妊娠的短期和长期影响。
