Pregnancy does not accelerate biological valve degeneration

Int J Cardiol. 2010 Dec 3;145(3):418-21. doi: 10.1016/j.ijcard.2010.04.095. Epub 2010 Jun 3.

Abstract

Background: Pregnancy in women with biological heart valve prosthesis might lead to a faster degeneration of the prosthesis. We analyzed the rate of prosthesis replacement and the outcome of pregnancies in women with biological valve prosthesis.

Methods: Between 1976 and 2006, 100 female patients aged 18-40 years at time of the study, underwent a valve replacement with a bioprosthesis or a homograft. At a mean interval of 10.8±8 years, 87 patients were evaluated by a questionnaire.

Results: A biological prosthesis was implanted in 45 patients (52%), while 42 patients (48%) received a homograft. After valve replacement, 33 patients (38%) had a total of 56 pregnancies with a live-birth rate of 77% (n=43). There were 9 (16%) miscarriages, 4 (7%) therapeutic abortions and no stillbirths. There was no maternal death, thromboembolic event or structural valve deterioration during pregnancy. Out of 87 patients, 31 (36%) required a valve re-replacement at a mean time of 9.5±5 years. Neither age, valve type, valve position nor pregnancy were a risk factor for a valve re-replacement. The freedom from valve re-replacement at 5 and 10 years, was 96±3% and 73±9%, respectively for patients after a pregnancy compared to 93±4% and 52±10%, respectively for patients without a pregnancy (p=0.2).

Conclusions: Pregnancy does not accelerate the risk for replacement of a biological heart valve prosthesis. Pregnancy in women with biological heart valves can be carried out without increased morbidity related to the implanted valve.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Heart Valve Diseases / epidemiology*
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis Implantation / statistics & numerical data*
  • Humans
  • Morbidity
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / epidemiology*
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Thromboembolism / epidemiology
  • Young Adult