Management of Valvular Disease During Pregnancy: Evolving Role of Percutaneous Treatment

Chiara Fraccaro; Noemie Tence; Giulia Masiero; Nicole Karam

doi:10.15420/icr.2020.06

Management of Valvular Disease During Pregnancy: Evolving Role of Percutaneous Treatment

Interv Cardiol. 2020 Jul 29:15:e10. doi: 10.15420/icr.2020.06. eCollection 2020 Apr.

Authors

Chiara Fraccaro¹, Noemie Tence², Giulia Masiero¹, Nicole Karam²

Affiliations

¹ Interventional Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Padua, Italy.
² Medico-Surgical Heart Valve Unit, Georges Pompidou European Hospital, University of Paris Paris, France.

Abstract

Valvular heart disease (VHD) is encountered in approximately 1% of pregnancies, significantly increasing both maternal and foetal risk. Rheumatic VHD remains the most common form in non-Western countries, whereas congenital heart disease dominates in the Western world. The risk of complications varies according to the type and severity of the underlying VHD. Moreover, pregnancy is a hypercoagulable state associated with increased risk of thromboembolism. The authors review the main VHDs encountered during pregnancy, and suggest management strategies based on the 2018 European Society of Cardiology recommendations for the management of pregnant women with VHD, providing an overview of classical and new transcatheter structural therapeutic options with a special focus on radiation exposure and anticoagulation drug management.

Keywords: Transcatheter structural interventions; aortic stenosis; mitral stenosis; pregnancy; rheumatic heart disease.

Publication types

Review