Deviri E, Yechezkel M, Levinsky L, Vidne B A, Levy M J
Thorac Cardiovasc Surg. 1984 Aug;32(4):266-8. doi: 10.1055/s-2007-1023401.
A 20-year-old woman required urgent replacement of a calcified prosthetic mitral porcine xenograft with a mechanical one during the 32nd week of pregnancy. Five weeks later the patient delivered a normal child. Following delivery the patient refused oral anticoagulant treatment and 7 months later she underwent emergency removal of a prosthetic valve thrombus. Six months later, still refusing anticoagulant treatment, she died of cerebral embolization. We suggest that the replacement of a degenerated biologic valve with another biologic valve should be considered in patients who refuse anticoagulant treatment and that patients with prosthetic xenografts should be kept under close medical follow-up, including echocardiography because of possible accelerated xenograft failure during and/or following pregnancy.
一名20岁女性在妊娠第32周时需要紧急将钙化的人工二尖瓣猪异种移植物更换为机械瓣膜。五周后，患者产下一名正常婴儿。分娩后，患者拒绝口服抗凝治疗，7个月后她接受了人工瓣膜血栓的紧急清除术。6个月后，她仍拒绝抗凝治疗，最终死于脑栓塞。我们建议，对于拒绝抗凝治疗的患者，应考虑用另一种生物瓣膜替换退化的生物瓣膜；对于有人工异种移植物的患者，由于在妊娠期间和/或之后可能加速异种移植物衰竭，应进行密切的医学随访，包括超声心动图检查。
