Fraccaro Chiara, Tence Noemie, Masiero Giulia, Karam Nicole
Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Padua, Italy.
Medico-Surgical Heart Valve Unit, Georges Pompidou European Hospital, University of Paris Paris, France.
Interv Cardiol. 2020 Jul 29;15:e10. doi: 10.15420/icr.2020.06. eCollection 2020 Apr.
Valvular heart disease (VHD) is encountered in approximately 1% of pregnancies, significantly increasing both maternal and foetal risk. Rheumatic VHD remains the most common form in non-Western countries, whereas congenital heart disease dominates in the Western world. The risk of complications varies according to the type and severity of the underlying VHD. Moreover, pregnancy is a hypercoagulable state associated with increased risk of thromboembolism. The authors review the main VHDs encountered during pregnancy, and suggest management strategies based on the 2018 European Society of Cardiology recommendations for the management of pregnant women with VHD, providing an overview of classical and new transcatheter structural therapeutic options with a special focus on radiation exposure and anticoagulation drug management.
在大约1%的妊娠中会出现心脏瓣膜病(VHD),这显著增加了孕产妇和胎儿的风险。风湿性心脏瓣膜病在非西方国家仍然是最常见的形式,而在西方世界先天性心脏病占主导地位。并发症的风险因潜在心脏瓣膜病的类型和严重程度而异。此外,妊娠是一种高凝状态,与血栓栓塞风险增加相关。作者回顾了妊娠期间遇到的主要心脏瓣膜病,并根据2018年欧洲心脏病学会关于心脏瓣膜病孕妇管理的建议提出管理策略,概述了经典和新型经导管结构治疗选择,特别关注辐射暴露和抗凝药物管理。