title: Outcomes of prosthetic valve replacement in women of child-bearing age.
abstract: OBJECTIVE
  The outcomes of pregnancy are more favorable for women with bioprostheses than for those with mechanical prostheses. However, bioprostheses are associated with a high reoperation rate in young women and it remains unclear whether these young women can give birth without any complications. We analyzed the outcomes of prosthetic valve replacement and investigated the effectiveness and problems associated with bioprostheses in women of child-bearing age in Japan.
  
  
  METHODS
  The subjects of this study were six consecutive young adult women aged under 40 years, who underwent prosthetic valve replacement between January 2007 and April 2016.
  
  
  RESULTS
  Bioprostheses were selected for four of these six women in consideration of their child-bearing age. Mechanical valves were selected for the other two women who underwent the Konno procedure and double valve replacement (AVR, MVR) in view of their high risk for reoperation. The cardiac operations, although without mortality or morbidity, were complex and some involved multi-time procedures. Three of the women with bioprostheses had uneventful term pregnancies.
  
  
  CONCLUSIONS
  These young women with bioprostheses were able to give birth safely; however, as multiple operations are often required, and bioprostheses may not be ideal for young women. Prosthetic valve selection for young women of child-bearing age requires adequate pregnancy counseling and long-term planning.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10, Nishiogu, Arakawa-ku, 116-8567, Tokyo, Japan. kataokago@yahoo.co.jp.
authors.forename: Go
authors.initials: G
authors.lastname: Kataoka
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10, Nishiogu, Arakawa-ku, 116-8567, Tokyo, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Asano
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10, Nishiogu, Arakawa-ku, 116-8567, Tokyo, Japan.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10, Nishiogu, Arakawa-ku, 116-8567, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Tatsuishi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, 2-1-10, Nishiogu, Arakawa-ku, 116-8567, Tokyo, Japan.
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000367:Age Factors; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012086:Reoperation / Q000706:statistics & numerical data; D012306:Risk; D055815:Young Adult
keywords: Pregnancy; Prosthetic valve; Young woman