A Report of a Case: Anesthetic Management of a Parturient with Severe Thrombotic Stenosis of a Mechanical Aortic Valve—An Exercise in Coordination of Subspecialties

Author:

Inyang Asuquo N.1,Jackson Mark,Kumar Ashok,Nychka Andre,Leyvi Galina,Zhuravlev Ilya2,Plestis Konstadinos3,Wasnick John2

Affiliation:

1. Department of Anesthesia, Montefiore Medical Center/Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467

2. Departments of Anesthesiology Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY

3. Departments of Cardiothoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY

Abstract

The pregnant woman with valvular heart disease presents significant challenges to the obstetric, anesthesiology, and cardiology teams. Although successful outcomes for both mother and fetus are possible with coordinated medical care, the patient with a prosthetic valve who requires systemic anticoagulation provides a dilemma of insufficient anticoagulation leading to valve thrombosis versus the risks of maternal perinatal hemorrhage or fetal effects from oral or parenteral anticoagulants. This case report describes the peripartum management of a patient at 27 weeks' gestation with thrombus ona prosthetic aortic valve.

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,Cardiology and Cardiovascular Medicine

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