Christian
Well-known member
I've decided to keep a little journal here to add to the group's knowledge base. Hopefully, someone will learn something from all this.
Let me start off by saying that my wife is pregnant, but very newly so. There's obviously no guarantees that she won't miscarry -- or even that this isn't all some giant pregnancy test error. So don't be floored if this thread abruptly ends.
My wife is a 30 year old lawyer. She was born with a heart murmur. The origin of the murmur was determined to be mitral valve prolapse when she was 13 years old. Her valve isn't really "floppy" in the standard sense. It's just shaped oddly and is myxomatous.
My wife's heart readings have been "flat" (unchanged) since 1995. She has moderate to severe mitral regurgitation (3 - 4+). Her EF is 69% (measured via MUGA). Her LVIDD is 5.0 cm, LVIDS is 3.0 cm. LA is 3.8 cm. She exercises to 15 mets during each stress test (an excellent result), at which point the technicians let her stop. She's always been wholly asymptomatic. She has no stenosis.
We live in Pittsburgh. We have three relevant doctors in Pittsburgh - a local cardiologist, a cardiologist that specializes in taking women with MR through pregnancies, and a high risk obstetrician. We also, of course, have a family doctor and a general gynecologist. And we regularly visit a world-renowned valve specialist at the Cleveland Clinic. We consider him to be our "primary" cardiologist.
This platoon of doctors is no accident. We sought numerous opinions before deciding to try to have a baby. I'd recommend that anyone in our shoes get at least three opinions. Doctors sometimes have tunnel vision -- you get a fantastic array of ideas by exploring more and more opinions.
There isn't much on the web in the way of guidance. I've done about a zillion searches, and always end up in the same spot:
"Mitral regurgitation is usually tolerated well in pregnancy, mainly because of left ventricular unloading due to the physiologic decrease in systemic vascular resistance (SVR)."
Note the word "usually." We are facing some risk. Our doctors feel the risk of heart related complications during this pregnancy is 2-5%. She could experience rythym problems, hypertension, post-delivery problems, etc.
We considered those risks and a few other factors when reaching our decision:
1. It's a bit too early for reparative surgery. My wife will almost certainly need valve surgery someday. But pushing forward now would be very aggressive, particularly considering:
2. There's no guarantee my wife would get a repair. Her odds of a repair have been quoted between 85 - 99%. We use the number "90%" when making our decisions.
3. We hit 30, and the biological clock started to tick.
4. Now is a great time for us in terms of career flexibility and financial security.
Basically, we had three choices: we could forgo having natural children altogether, we could push ahead with a *very* early surgical procedure and gamble on good results that would allow us to have a child in a couple of years, or we could push ahead with a natural pregnancy now and face the stated risks. We made our decision a few weeks ago and luckily had immediate results.
I'll post updates on and off as things progress. We've got several preliminary appointments lined up over the next few weeks. The "hard core" appointments start in May, when we'll visit the Cleveland Clinic for a "16 weeks gestation evaluation."
Keep your fingers crossed for us. My wife is an amazing person, and she really deserves the best.
Let me start off by saying that my wife is pregnant, but very newly so. There's obviously no guarantees that she won't miscarry -- or even that this isn't all some giant pregnancy test error. So don't be floored if this thread abruptly ends.
My wife is a 30 year old lawyer. She was born with a heart murmur. The origin of the murmur was determined to be mitral valve prolapse when she was 13 years old. Her valve isn't really "floppy" in the standard sense. It's just shaped oddly and is myxomatous.
My wife's heart readings have been "flat" (unchanged) since 1995. She has moderate to severe mitral regurgitation (3 - 4+). Her EF is 69% (measured via MUGA). Her LVIDD is 5.0 cm, LVIDS is 3.0 cm. LA is 3.8 cm. She exercises to 15 mets during each stress test (an excellent result), at which point the technicians let her stop. She's always been wholly asymptomatic. She has no stenosis.
We live in Pittsburgh. We have three relevant doctors in Pittsburgh - a local cardiologist, a cardiologist that specializes in taking women with MR through pregnancies, and a high risk obstetrician. We also, of course, have a family doctor and a general gynecologist. And we regularly visit a world-renowned valve specialist at the Cleveland Clinic. We consider him to be our "primary" cardiologist.
This platoon of doctors is no accident. We sought numerous opinions before deciding to try to have a baby. I'd recommend that anyone in our shoes get at least three opinions. Doctors sometimes have tunnel vision -- you get a fantastic array of ideas by exploring more and more opinions.
There isn't much on the web in the way of guidance. I've done about a zillion searches, and always end up in the same spot:
"Mitral regurgitation is usually tolerated well in pregnancy, mainly because of left ventricular unloading due to the physiologic decrease in systemic vascular resistance (SVR)."
Note the word "usually." We are facing some risk. Our doctors feel the risk of heart related complications during this pregnancy is 2-5%. She could experience rythym problems, hypertension, post-delivery problems, etc.
We considered those risks and a few other factors when reaching our decision:
1. It's a bit too early for reparative surgery. My wife will almost certainly need valve surgery someday. But pushing forward now would be very aggressive, particularly considering:
2. There's no guarantee my wife would get a repair. Her odds of a repair have been quoted between 85 - 99%. We use the number "90%" when making our decisions.
3. We hit 30, and the biological clock started to tick.
4. Now is a great time for us in terms of career flexibility and financial security.
Basically, we had three choices: we could forgo having natural children altogether, we could push ahead with a *very* early surgical procedure and gamble on good results that would allow us to have a child in a couple of years, or we could push ahead with a natural pregnancy now and face the stated risks. We made our decision a few weeks ago and luckily had immediate results.
I'll post updates on and off as things progress. We've got several preliminary appointments lined up over the next few weeks. The "hard core" appointments start in May, when we'll visit the Cleveland Clinic for a "16 weeks gestation evaluation."
Keep your fingers crossed for us. My wife is an amazing person, and she really deserves the best.
