Pregnancy and aortic valve regurgitation

Women with aortic valve regurgitation who want to have children have some special considerations because the condition—with or without symptoms—can increase maternal and fetal risk.

If possible, you should try to have valve replacement surgery before you conceive. But many pregnant women with aortic valve regurgitation have successful pregnancies. This requires careful medical attention using a combination of medicines that flush excess fluids out of their system (diuretics) and medicines to relax and expand the blood vessels (vasodilators). Even simple treatments, such as plenty of bed rest and avoiding lying flat, can play an important role in a safe pregnancy.

You are at higher risk for complications with pregnancy if you have a marked limitation on physical activity or are unable to carry on any physical activity without discomfort (New York Heart Association heart failure functional class III to class IV) or if your regurgitation is caused by Marfan's syndrome, a disorder of the body's connective tissue. If you have NYHA class III or IV symptoms, you may need to have valve replacement surgery while you are pregnant.

If you are considering pregnancy and you have aortic valve regurgitation, you should get more advice from a multidisciplinary medical team that can give more information about your risk factors and long-term outcome.

If you plan to or may become pregnant after heart valve replacement, you need to consider the following:

  • Your aortic valve can be replaced with either a mechanical or biological valve.
  • Anticoagulants, also called blood-thinning medicines, may be needed after valve replacement surgery to prevent blood clots. Anticoagulants are needed over the long term if the replacement valve is mechanical.
  • If you choose a mechanical valve, you should avoid using the anticoagulant warfarin (such as Coumadin), because it can cause birth defects. Work with your doctor to choose an anticoagulant (such as heparin) that is safe for you to use during pregnancy.
  • Anticoagulants are not needed long-term with biological replacement valves. But biological valves do not last as long as mechanical valves. They last about 10 to 15 years.

Last Updated: January 7, 2010

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