CC BY-NC-ND 4.0 · Indian J Cardiovasc Dis Women WINCARS 2022; 07(01): 034-038
DOI: 10.1055/s-0041-1740354
Case Report

Mechanical Prosthetic Valve Thrombus in a Term Pregnant Woman Presenting as Acute Heart Failure: Case Report and Review of Literature

Kumari Gethu
1   Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Nivetida Jha
1   Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
1   Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Veena Pampapati
1   Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
2   Department of Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Ajith Ananthakrishnan Pillai
2   Department of Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
› Author Affiliations

Abstract

Cardiovascular disease in pregnancy contributes to a significant proportion of death worldwide. Though pregnancy-associated myocardial infarction and aortic dissection are the common causes of adverse cardiac events in developed countries, rheumatic heart diseases continue to be the important reason for cardiovascular morbidity and mortality in developing countries. The risk of adverse cardiac outcome is dependent on the type and severity of valvular abnormality, functional status, left ventricular function, and pulmonary arterial pressure. Managing a pregnant woman with a mechanical heart valve prosthesis is challenging because of the difficulty in achieving optimal anticoagulation in the presence of hypercoagulability. Mitral valve thrombus is a life-threatening event and women can present with acute heart failure or thromboembolic events. We report successful management of a 26-year-old primigravida with rheumatic heart disease diagnosed to have huge thrombus on mechanical prosthetic mitral valve presented with acute heart failure at 36 weeks. She received multidisciplinary care and underwent concurrent cesarean section followed by thrombectomy under cardiopulmonary bypass. She had a good recovery following surgery and the complexity surrounds the management merit the presentation with a review of management strategies for a women with mechanical prosthetic heart valve in pregnancy.

Author Contributions

S.R. conceived the idea and guided in drafting the manuscript. All authors contributed to the manuscript. K.G., N.J., and S.R. wrote the first draft of the manuscript. V.P., H.M., and A.A.P. verified the draft. All authors contributed to revising and finalization of the manuscript. S.R. (corresponding author) guarantees all aspects of the reliability and freedom from bias of the data presented




Publication History

Article published online:
18 April 2022

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