title: Severe bioprosthetic mitral valve stenosis in pregnancy.
abstract: A 21-year-old woman in the 16th week of pregnancy was admitted due to acute presentation of severe exertional dyspnea. She had undergone mitral valve replacement (MVR) with bioprosthetic valve for infective endocarditis 2 years ago. She developed congestive heart failure from mitral bioprosthetic valve stenosis due to early structural valve deterioration. She also had severe pulmonary hypertension and underwent a redo MVR using a mechanical valve prosthesis with good maternal outcome but fetal demise. This report brings up the debate about what type of valve should be used in women in reproductive age, and discusses the management of severe mitral stenosis and stenosis of a bioprosthetic valve during pregnancy. Surgical options can almost always be delayed until fetal maturity is achieved and a simultaneous cesarean section can be performed. However, under certain circumstances when the maternal welfare is in jeopardy the surgical intervention is mandatory even before the fetus reaches viability.
authors.affiliation: Department of Medicine, University of Miami/Jackson Memorial Hospital, 1611 NW 12th Avenue, Central Building, Room 600D, Miami, FL, 33136, USA. jersonmunozmendoza@gmail.com.
authors.forename: Jerson
authors.initials: J
authors.lastname: Munoz-Mendoza
authors.affiliation: Department of Medicine, University of Miami/Jackson Memorial Hospital, 1611 NW 12th Avenue, Central Building, Room 600D, Miami, FL, 33136, USA.
authors.forename: Veronica
authors.initials: V
authors.lastname: Pinto Miranda
authors.affiliation: Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
authors.forename: Tanyanan
authors.initials: T
authors.lastname: Tanawuttiwat
authors.affiliation: Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Badiye
authors.affiliation: Division of Cardiology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
authors.forename: Sandra V
authors.initials: SV
authors.lastname: Chaparro
mesh_terms: D001705:Bioprosthesis / Q000009:adverse effects*; D002585:Cesarean Section; D004697:Endocarditis, Bacterial / Q000601:surgery; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D055815:Young Adult
keywords: Bioprosthesis; Mitral stenosis; Pregnancy; Redo mitral surgery