Mechanical Tricuspid Valve Thrombosis and Pregnancy

Mechanical tricuspid valve thrombosis during pregnancy is a rare but extremely high-risk condition due to the thrombogenic nature of tricuspid prostheses and the hypercoagulable state of pregnancy, which complicates anticoagulation management. This article reports the case of a 39-year-old pregnant woman who developed thrombosis of a mechanical tricuspid valve after switching from warfarin to low-molecular-weight heparin. Owing to her hemodynamic stability, a conservative approach with intensified anticoagulation and close multidisciplinary monitoring was adopted, allowing continuation of the pregnancy without maternal clinical deterioration. Partial echocardiographic improvement was observed. Delivery was achieved by planned ischemic cesarean section to minimize hemodynamic stress, resulting in a stable preterm neonate. The patient recovered well and subsequently underwent elective replacement of the mechanical valve with a bioprosthesis postpartum. This case highlights the complexity of diagnosing and managing mechanical tricuspid valve thrombosis during pregnancy and emphasizes the importance of individualized, multidisciplinary care, as well as the selective use of ischemic cesarean section in extreme-risk scenarios.