title: 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.
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 on a prosthetic aortic valve.
authors.affiliation: Department of Anesthesiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA. ainyang@montefiore.org
authors.forename: Asuquo N
authors.initials: AN
authors.lastname: Inyang
authors.forename: Mark
authors.initials: M
authors.lastname: Jackson
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.forename: Andre
authors.initials: A
authors.lastname: Nychka
authors.forename: Galina
authors.initials: G
authors.lastname: Leyvi
authors.forename: Ilya
authors.initials: I
authors.lastname: Zhuravlev
authors.forename: Konstadinos
authors.initials: K
authors.lastname: Plestis
authors.forename: John
authors.initials: J
authors.lastname: Wasnick
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000925:Anticoagulants / Q000627:therapeutic use; D001024:Aortic Valve Stenosis / Q000150:complications*; D001037:Aphasia / Q000209:etiology; D003328:Coronary Thrombosis / Q000150:complications*; D005260:Female; D006350:Heart Valve Prosthesis; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D010348:Patient Care Team; D011183:Postoperative Complications / Q000523:psychology; D011247:Pregnancy
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight