EMERGENCY CESAREAN SECTION WITH REDO MITRAL VALVE REPLACEMENT FOR ACUTE PROSTHETIC VALVE DYSFUNCTION: A CASE REPORT
I. KHOLOD,
E. BUHMAN,
S. GRISARU-GRANOVSKY,
T. AVITAN,
S. TAGER,
A. NIR,
A. TVITO,
Y. GOZAL,
A. IOSCOVICH
Affiliations
I. KHOLOD
Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
E. BUHMAN
Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
S. GRISARU-GRANOVSKY
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
T. AVITAN
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
S. TAGER
Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
A. NIR
Department of Cardiology, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
A. TVITO
Department of Hematology, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
Y. GOZAL
Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
A. IOSCOVICH
Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with Hebrew University, Jerusalem, Israel
Objective: Cardiovascular diseases emerge as one of the leading causes of maternal morbidity and mortality in developed countries. These risks are even higher in women with prosthetic cardiac valves. The core of the care for these women and the fetus during the hypercoagulable state of the pregnancy and postpartum period is the achievement of coagulation control using adjusted anticoagulation therapy protocols. A multidisciplinary team that includes obstetricians, cardiologists, hematologists, and anesthesiologists in a referral center is essential for an optimal maternal-fetal outcome. In particular, these measures are directed at preventing one of the most serious complications associated with mechanical valve dysfunction. The dysfunctional valve in the mitral position increases maternal and fetal mortality by 30%, especially in the presence of heart failure symptoms. Here we present a case of a 32-week pregnant woman diagnosed with dysfunction of the mechanical mitral valve (MV) and an emergency multidisciplinary approach to her treatment.
