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Patient–Prosthesis Mismatch in Pregnancy

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

doi: 10.1097/AOG.0000000000000074
Case Report

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.

Patient–prosthesis mismatch is a severe complication after prosthetic valve replacement surgery that may pose significant risk to maternal health during pregnancy.

Department of Obstetrics & Gynecology, University of California Irvine Medical Center, Orange, and Miller Children's Hospital-Long Beach Memorial Medical Center, Long Beach, California.

Corresponding author: Robert C. Johnston, MD, Resident Physician, Department of Obstetrics & Gynecology, UC Irvine Medical Center, 101 The City Drive, Building 56, Suite 800, ZOT 3200 Orange, CA 92868; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.