Key result
Emergent beating-heart AVR with normothermic CPB successfully treats mechanical valve thrombosis during pregnancy.
Case Report (n=1)
Beating-heart aortic valve replacement with normothermic CPB may be a useful strategy in pregnant patients to minimize fetal risks.
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May support consideration in select pregnant valve thrombosis cases; leaves open need for prospective validation before practice change.
A 23-year-old woman with a history of previous bileaflet mechanical aortic valve replacement presented in acute heart failure at 27 weeks of gestation. Transthoracic echocardiography (TEE) demonstrated minimal leaflet excursion consistent with valve thrombosis. The patient underwent emergent surgery with normothermic cardiopulmonary bypass (CPB), and beating-heart technique for valve replacement. This novel strategy for aortic valve replacement is being presented as being particularly useful in pregnant patients whose fetuses are at risks of hypothermia, hemodilution, and hyperkalemia during CPB.
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Tehrani et al. (2004) conducted a case report in Acute heart failure due to mechanical aortic valve thrombosis in pregnancy (n=1). Emergent surgery with normothermic cardiopulmonary bypass and beating-heart technique for aortic valve replacement was evaluated. Emergent beating-heart aortic valve replacement with normothermic cardiopulmonary bypass was successfully performed in a 23-year-old pregnant woman with mechanical valve thrombosis.
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