Pregnancy in Women with Prosthetic Heart Valves Registry Of Pregnancy And Cardiac disease: ROPAC Jolien Roos-Hesselink Roger Hall On behalf of the ROPAC investigators Iris van Hagen Titia Ruijs Waltraut Merz Sorel Goland Harald Gabriel Malgorzata Lelonek Olga Trojnarska Wael Al Mahmeed Hajnalka Balint Zeinab Ashour Helmut Baumgartner Eric Boersma EURObservational Research Programme
Pregnancy in Women with Prosthetic Heart Valves R egistry O f P regnancy A nd C ardiac disease: ROPAC. Iris van Hagen Titia Ruijs Waltraut Merz Sorel Goland Harald Gabriel Malgorzata Lelonek Olga Trojnarska Wael Al Mahmeed Hajnalka Balint Zeinab Ashour Helmut Baumgartner - PowerPoint PPT Presentation
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Pregnancy in Women with Prosthetic Heart Valves
Registry Of Pregnancy And Cardiac disease: ROPAC
Jolien Roos-HesselinkRoger Hall
On behalf of the ROPAC investigators
Iris van HagenTitia Ruijs
Waltraut MerzSorel Goland
Harald GabrielMalgorzata Lelonek
Olga Trojnarska
Wael Al MahmeedHajnalka BalintZeinab Ashour
Helmut BaumgartnerEric Boersma
EURObservational Research Programme
I have nothing to disclose.
EURObservational Research Programme
Background
Pregnancy• Haemodynamic burden• Hypercoagulable state
Is a mechanical valve a risk factor for adverse outcome?
• Pregnant women with a mechanical valve prosthesis are at high risk: Event-free pregnancy resulting in a live birth was 58% versus 78% in other cardiac patients.
• There is a wide variety in used regimes for anticoagulation
• Vitamin k antagonists seem associated with high offspring mortality (miscarriages)
• Heparin in the first trimester was associated with valve thrombosis
• Not one regime turned out to be clearly optimal
EURObservational Research Programme
Clinical implications
• Pre-pregnancy counseling performed by an experienced specialist is mandatory explaining the different treatment options and their complication rates.
• After providing extensive information, a shared-decision should be searched for towards the best regime for the individual patient.
• All patients with a mechanical valve are at high risk during pregnancy and therefore the care for these patients should be concentrated in a few specialized centers
Speaker
Acknowledgements: EORP Team and ROPAC investigators