Key result
Successful ViV TMVR enables uncomplicated delivery in a pregnant woman with severe bioprosthetic mitral stenosis.
Why the study?
Does valve-in-valve transcatheter mitral valve replacement safely improve hemodynamics and allow for successful delivery in pregnant patients with severe bioprosthetic mitral valve stenosis?
Does valve-in-valve transcatheter mitral valve replacement safely improve hemodynamics and allow for successful delivery in pregnant patients with severe bioprosthetic mitral valve stenosis?
Valve-in-valve transcatheter mitral valve replacement is a feasible and effective strategy to stabilize pregnant patients with severe bioprosthetic mitral valve stenosis, allowing for safe continuation of pregnancy and delivery.
May warrant consideration in pregnant patients with bioprosthetic mitral valve stenosis; extends transcatheter options but remains hypothesis-generating.
Abstract A 26-year-old woman at 14 weeks gestation with her third pregnancy presented with severe bioprosthetic mitral valve stenosis, which represents very high maternal and fetal risk. Pregnancy termination was recommended but declined, and valve surgery was deemed to be of prohibitive risk. After multidisciplinary discussion, she underwent valve-in-valve transcatheter mitral valve replacement in the second trimester. She had an uncomplicated vaginal delivery at term. This represents a novel use of transcatheter valve replacement to stabilize a pregnant patient with a high–risk valvular lesion. This approach may be considered after multidisciplinary discussion in appropriately selected patients.
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Hoffmann et al. (2026) studied this question. Valve-in-valve transcatheter mitral valve replacement was successfully performed in a pregnant woman with severe bioprosthetic mitral valve stenosis, leading to an uncomplicated delivery.
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