Cardio-Obstetrics Team-Based Management of a Pregnant Patient With Severe Bioprosthetic Aortic Valve Disease

Figures

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  Figure 1. Spectral Doppler Bioprosthetic Aortic Valve Replacement LVOT VTI, Early Second Trimester The left ventricular outflow tract (LVOT) velocity time integral (VTI) was 29, spectral Doppler aortic valve early second trimester. VTI was 105, dimensionless index was 0.28, and mean aortic valve replacement gradient was 46.4 mm Hg, indicating moderate stenosis. PG = pressure gradient; PW = pulsed wave Doppler; SV = stroke volume; Vmax = peak velocity; Vmean = mean velocity.

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  Figure 2. Spectral Doppler Bioprosthetic Aortic Valve Replacement Aortic VTI, Early Second Trimester The LVOT VTI was 29, spectral Doppler Aortic valve early second trimester. VTI was 105, dimensionless index was 0.28, and mean aortic valve (AV) replacement gradient was 46.4 mm Hg, indicating moderate stenosis. AVA = aortic valve area; CW = continuous wave Doppler; other abbreviations as in Figure 1.

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  Figure 3. Spectral Doppler Bioprosthetic AV Replacement Aortic Regurgitation, Late Second Trimester Pressure half time was 148 ms, mean AV replacement gradient was 67 mm Hg, and there was severe stenosis and regurgitation. Abbreviations as in Figures 1 and 2.

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  Figure 4. Spectral Doppler Bioprosthetic AV Replacement Aortic Stenosis, Late Second Trimester Pressure half time was 148 ms, mean AV replacement gradient was 67 mm Hg, and there was severe stenosis and regurgitation. Vel = velocity; other abbreviations as in Figures 1 and 2.

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  Figure 5. Dose Reduced TAVR CT to Evaluate Size and Coronary Height for Valve in Valve TAVR Dose-reduced computed tomography transcatheter aortic valve replacement for valve size and coronary distance for valve-in-valve planning within degenerated bioprosthetic aortic valve replacement. Coronary height was acceptable with no risk for coronary obstruction, valve circumference of 72 mm acceptable for a 26 mm Medtronic CoreValve Evolut. RCA = right coronary artery.