Shemin R J, Phillippe M, Dzau V
Clin Cardiol. 1986 Jun;9(6):299-301. doi: 10.1002/clc.4960090614.
A 31-year-old female had an ascending aortic conduit with a Bjork-Shiley valve placed for an aortic dissection. A year later she became pregnant and was placed on heparin instead of coumadin therapy. She then developed a distal aortic dissection and was hospitalized for close medical monitoring of fetal status and maturity. At 33 weeks of gestation the aortic valve thrombosed, resulting in pulmonary edema and cardiac arrest. Emergency cesarean section and replacement of the aortic valve and ascending aortic conduit was successful in salvaging mother and child. Both are well at 2 years followup. The case illustrates the hazards of prosthetic valves in pregnant patients and cardiac surgery during pregnancy. These issues are reviewed along with the details leading to successful surgical management.
一名31岁女性因主动脉夹层置入带 Bjork-Shiley 瓣膜的升主动脉管道。一年后她怀孕，改用肝素而非华法林治疗。随后她发生了远端主动脉夹层，因需密切监测胎儿状态和成熟度而住院。妊娠33周时主动脉瓣血栓形成，导致肺水肿和心脏骤停。紧急剖宫产以及主动脉瓣和升主动脉管道置换成功挽救了母婴。随访2年时母婴状况良好。该病例说明了人工瓣膜在妊娠患者中的风险以及妊娠期心脏手术的风险。本文在回顾这些问题的同时，还详细介绍了成功进行手术治疗的过程。
