Obstetrics & Gynecology

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Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000074
Case Report

Patient–Prosthesis Mismatch in Pregnancy

Johnston, Robert C. MD; Swank, Morgan L. MD; Shrivastava, Vineet K. MD; Hameed, Afshan B. MD

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Abstract

BACKGROUND: Patient–prosthesis mismatch is a known and severe complication after aortic valve repair in the general population. There is a paucity of literature regarding this condition in pregnancy.

CASE: We present the clinical course of a pregnant woman with severe patient–prosthesis mismatch after aortic valve replacement. After extensive workup, the patient underwent aortic valve replacement, enlargement of the aortic root, and placement of a larger prosthetic valve at 21 weeks of gestation. Her postoperative course was complicated by fetal death.

CONCLUSION: Cardiopulmonary bypass and aortic valve replacement present a multitude of risks to maternal and fetal health. The obstetrician managing pregnant women with prosthetic heart valves should be aware of the complications that may arise, including patient–prosthesis mismatch.

© 2014 by The American College of Obstetricians and Gynecologists.

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