{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:04:54Z","timestamp":1773414294558,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The management of anticoagulation for mechanical heart valves during pregnancy poses a unique challenge. Mechanical valve thrombosis is a devastating complication for which surgery is often the treatment of choice. However, cardiac surgery for prosthetic valve dysfunction in pregnant patients confers a high risk of maternofetal morbidity and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 39-year-old woman in her first pregnancy at 30 weeks gestation presented to hospital with a mechanical mitral valve thrombosis despite therapeutic anticoagulation with low-molecular-weight heparin. She underwent an emergent caesarean section followed immediately by a bioprosthetic mitral valve replacement. This occurred after careful planning and organization on the part of a large multidisciplinary team.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>A proactive, rather than reactive, approach to the surgical management of a mechanical valve thrombosis in pregnancy will maximize the chances of successful maternal and fetal outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac424","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T21:15:36Z","timestamp":1667337336000},"source":"Crossref","is-referenced-by-count":3,"title":["The multidisciplinary management of a mechanical mitral valve thrombosis in pregnancy: a case report and review of the literature"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4518-4731","authenticated-orcid":false,"given":"Jennifer M","family":"Wright","sequence":"first","affiliation":[{"name":"Department of Medicine, McGill University, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Bottega","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Therrien","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jewish General Hospital , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roupen","family":"Hatzakorzian","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"},{"name":"Department of Critical Care Medicine, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Buithieu","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Shum-Tim","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Wou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amale","family":"Ghandour","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Li Pi Shan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9140-8735","authenticated-orcid":false,"given":"Isabelle","family":"Malham\u00e9","sequence":"additional","affiliation":[{"name":"Department of Medicine, McGill University, McGill University Health Centre , Montr\u00e9al, Quebec , Canada"},{"name":"Center for Outcomes Research and Evaluation, Research institute of the McGill University Health Centre , Montr\u00e9al, Quebec , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,11,1]]},"reference":[{"key":"2024051617523635800_ytac424-B1","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1161\/CIRCULATIONAHA.115.015242","article-title":"Pregnancy in women with a mechanical heart valve: data of the European society of cardiology registry of pregnancy and cardiac disease (ROPAC)","volume":"132","author":"van Hagen","year":"2015","journal-title":"Circulation"},{"key":"2024051617523635800_ytac424-B2","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1111\/1471-0528.14478","article-title":"Pregnancy outcomes in women with mechanical prosthetic heart valves: a prospective descriptive population based study using the United Kingdom obstetric surveillance system (UKOSS) data collection system","volume":"124","author":"Vause","year":"2017","journal-title":"Bjog"},{"key":"2024051617523635800_ytac424-B3","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1093\/eurheartj\/ehx032","article-title":"Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis","volume":"38","author":"D\u2019Souza","year":"2017","journal-title":"Eur Heart J"},{"key":"2024051617523635800_ytac424-B4","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1016\/j.jacc.2020.11.018","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American college of cardiology\/American heart association joint committee on clinical practice guidelines","volume":"77","author":"Otto","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2024051617523635800_ytac424-B5","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC guidelines for the management of cardiovascular diseases during pregnancy","volume":"39","author":"Regitz-Zagrosek","year":"2018","journal-title":"Eur Heart J"},{"key":"2024051617523635800_ytac424-B6","first-page":"524","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European society of cardiology (ESC) and the European association for cardio-thoracic surgery (EACTS)","volume":"75","author":"Vahanian","year":"2022","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2024051617523635800_ytac424-B7","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1111\/jth.15213","article-title":"Communication from the ISTH SSC subcommittee on women\u2019s health issues in thrombosis and haemostasis: a survey on anticoagulation for mechanical heart valves in pregnancy","volume":"19","author":"Malham\u00e9","year":"2021","journal-title":"J Thromb Haemost"},{"key":"2024051617523635800_ytac424-B8","volume-title":"Preventive services task force evidence syntheses, formerly systematic evidence reviews. Aspirin use to prevent preeclampsia and related morbidity and mortality","author":"Henderson","year":"2021"},{"key":"2024051617523635800_ytac424-B9","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1016\/j.cjca.2021.06.021","article-title":"Canadian Cardiovascular society: clinical practice update on cardiovascular management of the pregnant patient","volume":"37","author":"Windram","year":"2021","journal-title":"Can J Cardiol"},{"key":"2024051617523635800_ytac424-B10","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1038\/nrcardio.2015.172","article-title":"Use of medication for cardiovascular disease during pregnancy","volume":"12","author":"Pieper","year":"2015","journal-title":"Nat Rev Cardiol"},{"key":"2024051617523635800_ytac424-B11","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1136\/heartjnl-2015-308199","article-title":"Valvular heart disease and pregnancy part II: management of prosthetic valves","volume":"103","author":"Bhagra","year":"2017","journal-title":"Heart"},{"key":"2024051617523635800_ytac424-B12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJM199507063330103","article-title":"Optimal oral anticoagulant therapy in patients with mechanical heart valves","volume":"333","author":"Cannegieter","year":"1995","journal-title":"N Engl J Med"},{"key":"2024051617523635800_ytac424-B13","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1016\/j.amjcard.2018.07.020","article-title":"Outcomes and long-term effects of pregnancy in women with biologic and mechanical valve prostheses","volume":"122","author":"Batra","year":"2018","journal-title":"Am J Cardiol"},{"key":"2024051617523635800_ytac424-B14","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/S0735-1097(99)00044-3","article-title":"Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves","volume":"33","author":"Vitale","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"2024051617523635800_ytac424-B15","doi-asserted-by":"crossref","first-page":"1248.e1","DOI":"10.1016\/j.cjca.2015.11.005","article-title":"Anticoagulation regimens during pregnancy in patients with mechanical heart valves: a systematic review and meta-analysis","volume":"32","author":"Xu","year":"2016","journal-title":"Can J Cardiol"},{"key":"2024051617523635800_ytac424-B16","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1001\/archinte.160.2.191","article-title":"Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature","volume":"160","author":"Chan","year":"2000","journal-title":"Arch Intern Med"},{"key":"2024051617523635800_ytac424-B17","doi-asserted-by":"crossref","first-page":"e1159","DOI":"10.1161\/CIR.0000000000000503","article-title":"2017 AHA\/ACC focused update of the 2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"135","author":"Nishimura","year":"2017","journal-title":"Circulation"},{"key":"2024051617523635800_ytac424-B18","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1080\/14767058.2018.1434141","article-title":"Thrombolysis in pregnancy: a literature review","volume":"32","author":"Sousa Gomes","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2024051617523635800_ytac424-B19","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1161\/CIRCULATIONAHA.113.001145","article-title":"Thrombolytic therapy for the treatment of prosthetic heart valve thrombosis in pregnancy with low-dose, slow infusion of tissue-type plasminogen activator","volume":"128","author":"\u00d6zkan","year":"2013","journal-title":"Circulation"},{"key":"2024051617523635800_ytac424-B20","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1093\/eurheartj\/ehs486","article-title":"Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies","volume":"34","author":"Karthikeyan","year":"2013","journal-title":"Eur Heart J"},{"key":"2024051617523635800_ytac424-B21","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.athoracsur.2018.03.020","article-title":"Maternal and fetal outcome after cardiac operations during pregnancy: a meta-analysis","volume":"106","author":"Jha","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2024051617523635800_ytac424-B22","doi-asserted-by":"crossref","first-page":"e010628","DOI":"10.1161\/CIRCINTERVENTIONS.121.010628","article-title":"Transcatheter mitral valve implantation: current Status and future perspectives","volume":"14","author":"Russo","year":"2021","journal-title":"Circ Cardiovasc Interv"},{"key":"2024051617523635800_ytac424-B23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/2623608","article-title":"Preemptive ECMO cannulation in a patient with severe left ventricular systolic dysfunction undergoing cesarean delivery","volume":"2019","author":"Bui","year":"2019","journal-title":"Case Rep Anesthesiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac424\/46732186\/ytac424.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/11\/ytac424\/57707901\/ytac424.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/11\/ytac424\/57707901\/ytac424.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T18:01:21Z","timestamp":1715882481000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac424\/6790104"}},"subtitle":[],"editor":[{"given":"Rita","family":"Pavisini","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Giulio","family":"Russo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Annachiara","family":"Pingitore","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Reshma","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Fabienne","family":"Vervaat","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,11,1]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac424","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,11,1]]},"article-number":"ytac424"}}