Jones Sara I, Acuff Heather, Best Ryan, Gee Yen-Yen, Snow Sarah C, Agarwal Richa, Rosario Karen Flores, Gilner Jennifer B, Federspiel Jerome J, Meng Marie-Louise
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA.
JACC Case Rep. 2025 Jun 4;30(13):103536. doi: 10.1016/j.jaccas.2025.103536.
The limited available data on pregnancies among patients with left ventricular assist devices (LVADs) in situ shows elevated rates of maternal and fetal/neonatal morbidity and mortality. The first fully magnetically levitated device providing centrifugal continuous flow, HeartMate 3 (HM3, Abbott), is the only LVAD available in the United States since 2018 and has fewer adverse patient outcomes compared with previous devices.
A 32-year-old G5P2113 woman became pregnant 19 months after destination-therapy HM3 LVAD placement. Uncomplicated antepartum care and a cesarean delivery at 34 weeks under neuraxial anesthesia was facilitated by our institution's pregnancy heart team.
This represents the second reported HM3-supported pregnancy resulting in a live birth. Various barriers to care guided a shared anticoagulation plan, and no hemorrhagic or thrombotic complications occurred. Our intrapartum monitoring strategy facilitated a patient-centered delivery and postpartum experience while maintaining excellent patient safety.
关于左心室辅助装置（LVAD）植入患者妊娠的现有数据有限，显示母婴及胎儿/新生儿发病率和死亡率有所升高。首款提供离心式连续血流的全磁悬浮装置HeartMate 3（HM3，雅培公司）自2018年起成为美国唯一可用的LVAD，与之前的装置相比，患者不良结局较少。
一名32岁、孕5产2（1次足月产、1次早产、1次流产、3次现存子女）的女性在接受目标治疗的HM3 LVAD植入术后19个月怀孕。在我们机构的妊娠心脏团队的协助下，孕期护理顺利，34周时在神经轴麻醉下进行了剖宫产。
这是第二例报道的由HM3支持的妊娠并分娩活婴的病例。各种护理障碍促成了一个共享的抗凝方案，且未发生出血或血栓并发症。我们的产时监测策略促成了以患者为中心的分娩及产后体验，同时保持了极佳的患者安全性。
