Mitral valve thrombosis during pregnancy: favourable course of anticoagulation therapy

The Pregnant patients with a prosthetic mechanical valve are at high risk for valve thrombosis and the optimal treatment strategy in the pre-pregnancy period and during pregnancy itself is a matter of debate. Prosthetic heart valve (PHV) thrombosis is a rare condition with serious life-threatening complications diagnosed optimally by TOE followed by a radio-cinema; and which needs to be revaluated frequently by echocardiography transthoracic in case of an increase in trans valvular gradient. We report here a case of a 37-year-old woman, pregnant at 31 weeks of amenorrhea, with a double mitro-aortic mechanical replacement suspected dysfunction in front of an increase of trans-valvular gradient and confirmed on the radio cinema. The patient was treated with a low molecular weight heparin (LMWH); acetylsalicylic acid 160 mg daily; and oral anticoagulation (Acenocoumarol) with great clinical and biological results. In some cases; Pregnant patients with prosthetic valve thrombosis may be treated surgically, or with prolonged infusions of low-dose TPA. Repeated doses of low TPA can be administered at low doses.