Valve Regurgitation and Pregnancy

[Christian]

Jill and I went to her local (Pittsburgh) cardiologist yesterday for the semi-annual consultation. He says her heart's still a-ok (no enlargement, EF = 60%) despite her severe 3-4+ regurgitation.

He's definitely in favor of delaying the surgery. Her cardiologist at the Cleveland Clinic (Dr. Stewart) felt the same way last time we talked to him (August of 2000).

I explained that we were considering early surgery because we're considering having a baby. He thinks we should just have the baby now, since her heart's strong. Again, that's exactly what we heard from the Cleveland Clinic cardiologist.

Clearly, it's a major issue for us. If Dr. Cosgrove can't repair her valve (we won't get his thoughts for another two months), she'll likely be on coumadin for life. Coumadin = no baby.

Have any of you gone through a pregnancy with severe regurgitation caused by a prolapsing valve? I'm told that's the valve defect that can best handle a pregnancy (in contrast to stenosis), but I have done no research on the subject.

 

[Jean]

Baby & Valves

Baby & Valves

Christian: Back in the dark ages, I had a baby (now 31) with just about the same conditions as far as we knew with the methods available then. I knew I had a bileaflet aortic valve with some compromised EF. I honestly don't know the EF numbers...I was pretty ignorant of the whole thing then. I was not having any symptoms that were thought to be related to the valve regurgitation then although I question it now as my asthma has "mysteriously" disappeared since my surgery. I actually didn't have my surgery until two years ago...I feel so much more alive and energetic now, I think I should have had it sooner. I don't think I had any heart problems during pregnancy or delivery. I have no idea what doctors would have said today about my condiditon back then. Good luck in your investigations and decision makings.

 

[Mara]

Christian and Jill
I had a severly reguritating aortic valve (that was also stenotic) and since I have been about 21 my cardiologist told me I should not get pregnant. Now, that might just be me, but if I were in your wife's situation I'd want to know the risks. I'd go see an ob/gyn who specializes in high-risk pregnancies and would want to know all the things that could go wrong.

I was always told that if I got pregnant I'd have to be on heparin and in the hospital for most of it. Also, it's not so much the pregnancy as the delivery that is the bad part. You lose a lot of fluid very quickly and that's what makes your heart go under so much stress and pressure.

It's a big risk, and one I would not take. But, if you and Jill (mostly Jill) feel comfortable with it and the cardio and the ob/gyn are in agreement then go for it.



-Mara

 

[fdegranville]

Severe Aortic Regurgitation

Severe Aortic Regurgitation

Dear Christian & JIll,
I was diagnosed with mitral stenosis and aortic regurg 22 years ago. I was also advised to have children at that time if I wanted to take the risk. My LV was already enlarged at that time 5.9, but it really was the MS that they were more worried about as far as pregnancy was concerned. I eventually had two sons and I have also brought them up (oldest will be 18 on Friday). I did have problems after the second, but it was the worsening of the mitral stenosis. I still have my own valves, but I'm not sure for how much longer. Today there are medicines that can reduce AI, or the effects of it on your LV. Being followed by a specialist OB who has managed such cases really helps. It is also important that your OB and Cardiologist agree on your management, mine did not.

Best of luck with whatever you decide, to me it was well worth the risks involved.
fdeg

 

[LUVMyBirman]

Christian

I went through my entire pregnancy 6 years ago with 4+ reguirg and severe MVP with prolapsing leaflets. We did not know the severity of my condition at the time. My doctors all said it was fine. That I would live my enitre life without having to go to surgery. Boy were they wrong. Anyway, I continued on for almost three years post pregnancy before heading to surgery.

If CCF gives you the approval. Go for it. Sounds like your wife is in better condition that I. We still made it. Like any other invasive procedure, make sure they give her an antibiotic IV either before or after delivery.