Severe bicuspid aortic stenosis in pregnancy: balancing the risk of prematurity and maternal mortality

Cardiol Young. 2018 May;28(5):756-758. doi: 10.1017/S104795111800001X. Epub 2018 Feb 8.

Abstract

We report a case of combined severe aortic stenosis and regurgitation in a pregnant patient with a history of congenital bicuspid aortic valve. The patient presented at 22 weeks of gestation with angina and pre-syncopal symptoms. During her admission, she experienced intermittent episodes of non-sustained ventricular tachycardia and hypotension. A multi-disciplinary healthcare team was assembled to decide on the appropriate medical and surgical treatment options. At 28 weeks of gestation, the patient underwent a caesarean delivery immediately followed by a mechanical aortic valve replacement.

Keywords: Aortic stenosis; CHD; aortic regurgitation; bicuspid aortic valve; maternal mortality; pregnancy complication.

MeSH terms

  • Adult
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / etiology
  • Aortic Valve Stenosis / surgery*
  • Cesarean Section
  • Computed Tomography Angiography
  • Echocardiography
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Maternal Mortality
  • Mitral Valve Stenosis / complications*
  • Mitral Valve Stenosis / diagnosis
  • Mitral Valve Stenosis / surgery
  • Pregnancy
  • Pregnancy Complications, Cardiovascular*
  • Severity of Illness Index
  • Transcatheter Aortic Valve Replacement / methods*