K
KMB
I just wanted to take a minute to share my story with the members of this site and any other women who want to get pregnant and have a mechanical valve or are thinking of getting one.
After many oks and thumbs up from the medical community, my husband and I finally got the go ahead to have the baby. We tried and were successful and were excited finally getting to add another member to our family. It was the first baby for us. I have a mechanical ON-X valve put in May of 2005, so the plan was for me to take Lovenox all 9 months of the pregnancy, which I started taking 2 weeks before conception. We had learned that Coumadin can be very harmful to the fetus and goes through the placenta to the baby, Lovenox does not. We and my doctor felt very confident with our choice. There is not a lot published about valves and pregancy since it is just doesn't happen that often.
The months seemed to be flying by. My valve was doing fine, I was feeling great and the baby was going as he should be. I was followed by my regular OB, high risk OB, and my cardiologist. I was tested every week and sometimes twice a week with a blood test called anti-factor 10a, which checks the clotting, similar to INR checks. Every week but one I was in range, and at that the high end of the range.
At about 31 weeks of pregnancy I had some mild chest pain, but otherwise felt just fine. The pain felt like a dull ache. I notified my cardiologist and he recommended coming in to have an echo. The doctor informed us that the gradient, pressure on my valve, was at a 12. Normal people have a gradient of about 4 or 5. He did not know if this was due to my pregnancy or if something was wrong, so the next week I went in for a TEE. During the TEE they found a clot on my valve and I was admitted to the hospital and was told I would stay there for the duration of my pregnancy. Our world was turned upside down and I was crushed. I was administed IV heprin and could not leave the hospital. The next week we had another echo and the gradient went down to 8, so we were thinking that all was going great and the clot was dissolving itself. The next week we had the echo and it was back up to 12. We were not sure which echo was right, so the next week we had another echo and the gradient was now 17. I was not getting any better, only worse. We were really alarmed and were not sure what would happen if I suddenly went into labor.
We approached my doctor and said we wanted to be transferred to the Mayo clinic in Rochester, about 3 hours away from the current hospital and 5+ hours away from our home, but knew we needed specialized help to treat the problem. My doctor had already been in contact with the Mayo and we were all on the same page. I was transferred down by ambulance and the next day met with many doctors and had another echo. The gradient was 16. The plan of attack was to go through a dose of TPA- a clot busting drug which is very risky in the mitral valve. We had full faith in the doctor who recommended it. The next day we met with another doctor who said if we went the TPA route the risk of stroke was 20% - quite alarming. No one wants to have a stroke. My husband and I then met with a surgeon who suggested having a c-section and replace the valve all at once. Remembering what it felt like the first time I had replacement surgery I was so upset. How was I going to be able to care for my newborn child and recover from two surgeries at once. The risk of stroke was too high though, so we decided that we needed to do the surgeries. The doctors thought the clot was so bad that they wanted to do it that day, but then decided the next day was better.
The day of the surgery was intense. There was a team of caridac people, OB people and neonatal people all in the operating room. They could not put me fully out because they did not want to place any undo harm to the baby, so they gave me a PCP like drug and put me partially out. They put in all the lines and then put me all the way out. They did the c-section first and then the open heart surgery. The baby was born at 5 pounds 7 ounces - he was 4 weeks early. They rushed him to the NICU and he was placed on a breathing tube for about 12 hours. They then decided to replace the valve as the clot had taken up over 3/4ths of the valve. I have pictures of the valve and it is truely amazing that I am alive. The clot was huge and I was not feeling any symptoms before the surgery. The doctors could not believe I was not in heart failure. The surgeries were sucessful and I was up in the ICU by night. I was taken off the breathing tube at around midnight. The next day I was able to see my baby. He was so cute. We named him Carson. I was out of the hospital in about 5 days and feeling so much better than the first time I had the surgery. The baby stayed in the NICU for about 10 days as he learned how to eat and gained some strength.
It is now 3 weeks later and we are back home again. No one knows what went wrong, if the Lovenox did not work for me, if the valve was the problem, or if it was just that the blood is extra sticky during pregnancy. We chose to go ahead with the mechanical mitral valve the first time because the doctors said that getting pregnant with the valve would not be a problem with the proper anti-coagulation. I chose that valve because I did not want a tissue valve and then have the have the surgery again 10 years later. Had I known this all would have happened who knows what route we would have gone.
I just think it is so important to tell people about my story. No one thinks they are going to be the one that gets a clot. No one thinks that they are going to be the one that is going to be at the edge of dying. Thank god we had great doctors to turn to and everything turned out ok. My community and family sent up prayers too which I am sure helped. I am also a big believer in angels too because one was really watching out for me.
I hope that if you are thinking about getting pregnant and you have or are looking at valve choices you take my story into mind. I would not want anyone to go through what I had to. Mechanical Valves and pregnancy are just not a good combination.
After many oks and thumbs up from the medical community, my husband and I finally got the go ahead to have the baby. We tried and were successful and were excited finally getting to add another member to our family. It was the first baby for us. I have a mechanical ON-X valve put in May of 2005, so the plan was for me to take Lovenox all 9 months of the pregnancy, which I started taking 2 weeks before conception. We had learned that Coumadin can be very harmful to the fetus and goes through the placenta to the baby, Lovenox does not. We and my doctor felt very confident with our choice. There is not a lot published about valves and pregancy since it is just doesn't happen that often.
The months seemed to be flying by. My valve was doing fine, I was feeling great and the baby was going as he should be. I was followed by my regular OB, high risk OB, and my cardiologist. I was tested every week and sometimes twice a week with a blood test called anti-factor 10a, which checks the clotting, similar to INR checks. Every week but one I was in range, and at that the high end of the range.
At about 31 weeks of pregnancy I had some mild chest pain, but otherwise felt just fine. The pain felt like a dull ache. I notified my cardiologist and he recommended coming in to have an echo. The doctor informed us that the gradient, pressure on my valve, was at a 12. Normal people have a gradient of about 4 or 5. He did not know if this was due to my pregnancy or if something was wrong, so the next week I went in for a TEE. During the TEE they found a clot on my valve and I was admitted to the hospital and was told I would stay there for the duration of my pregnancy. Our world was turned upside down and I was crushed. I was administed IV heprin and could not leave the hospital. The next week we had another echo and the gradient went down to 8, so we were thinking that all was going great and the clot was dissolving itself. The next week we had the echo and it was back up to 12. We were not sure which echo was right, so the next week we had another echo and the gradient was now 17. I was not getting any better, only worse. We were really alarmed and were not sure what would happen if I suddenly went into labor.
We approached my doctor and said we wanted to be transferred to the Mayo clinic in Rochester, about 3 hours away from the current hospital and 5+ hours away from our home, but knew we needed specialized help to treat the problem. My doctor had already been in contact with the Mayo and we were all on the same page. I was transferred down by ambulance and the next day met with many doctors and had another echo. The gradient was 16. The plan of attack was to go through a dose of TPA- a clot busting drug which is very risky in the mitral valve. We had full faith in the doctor who recommended it. The next day we met with another doctor who said if we went the TPA route the risk of stroke was 20% - quite alarming. No one wants to have a stroke. My husband and I then met with a surgeon who suggested having a c-section and replace the valve all at once. Remembering what it felt like the first time I had replacement surgery I was so upset. How was I going to be able to care for my newborn child and recover from two surgeries at once. The risk of stroke was too high though, so we decided that we needed to do the surgeries. The doctors thought the clot was so bad that they wanted to do it that day, but then decided the next day was better.
The day of the surgery was intense. There was a team of caridac people, OB people and neonatal people all in the operating room. They could not put me fully out because they did not want to place any undo harm to the baby, so they gave me a PCP like drug and put me partially out. They put in all the lines and then put me all the way out. They did the c-section first and then the open heart surgery. The baby was born at 5 pounds 7 ounces - he was 4 weeks early. They rushed him to the NICU and he was placed on a breathing tube for about 12 hours. They then decided to replace the valve as the clot had taken up over 3/4ths of the valve. I have pictures of the valve and it is truely amazing that I am alive. The clot was huge and I was not feeling any symptoms before the surgery. The doctors could not believe I was not in heart failure. The surgeries were sucessful and I was up in the ICU by night. I was taken off the breathing tube at around midnight. The next day I was able to see my baby. He was so cute. We named him Carson. I was out of the hospital in about 5 days and feeling so much better than the first time I had the surgery. The baby stayed in the NICU for about 10 days as he learned how to eat and gained some strength.
It is now 3 weeks later and we are back home again. No one knows what went wrong, if the Lovenox did not work for me, if the valve was the problem, or if it was just that the blood is extra sticky during pregnancy. We chose to go ahead with the mechanical mitral valve the first time because the doctors said that getting pregnant with the valve would not be a problem with the proper anti-coagulation. I chose that valve because I did not want a tissue valve and then have the have the surgery again 10 years later. Had I known this all would have happened who knows what route we would have gone.
I just think it is so important to tell people about my story. No one thinks they are going to be the one that gets a clot. No one thinks that they are going to be the one that is going to be at the edge of dying. Thank god we had great doctors to turn to and everything turned out ok. My community and family sent up prayers too which I am sure helped. I am also a big believer in angels too because one was really watching out for me.
I hope that if you are thinking about getting pregnant and you have or are looking at valve choices you take my story into mind. I would not want anyone to go through what I had to. Mechanical Valves and pregnancy are just not a good combination.
