Case report: Management of mechanical aortic valve thrombosis during pregnancy

Pregnancy in women with mechanical valves has a high risk of both valve thrombosis and bleeding. We describe the case of a pregnant woman developing thrombosis of a mechanical aortic valve causing severe aortic stenosis without heart failure symptoms. The pregnancy was managed with heparin, and a high dose of warfarin was restarted soon after delivery. One month later transesophageal echocardiogram showed dissolution of the thrombosis, with restoration of the transvalvular gradients present after implantation. The management of pregnant patients with mechanical valves is complex and a multidisciplinary approach is essential.