Tissue valves and pregnancy

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kimfusca

Hello Everyone,
I'm new to posting, but as I might be scheduling surgery in the next few weeks, I thought I'd pose a question. I am 37 years old and I'd love have another child (I have one 2 1/2 year daughter now), so I am leaning towards a tissue valve. I was wondering if anyone out there has been in a similar situation as me, and how it worked out. Any more kids? Good experience or not?
 
Welcome Kim. If you are wanting more biological children then it would be very advisable to have a tissue valve replacement. Coumadin is very difficult on the developing baby in the first trimester.

Welcome! Glad you found us.
 
Welcome, Kim. I can certainly understand your dilemma regarding valve choice, especially if you'd like to have more kids. Pregnancy with a mechanical is possible but very, very difficult. I found a few threads by one of our members named Willow who is having a second child with a mechanical valve. The first link is from her (Waltsmom), and the second link is from her husband, Anthony, who wrote a long post about their experience. I thought you may want to see both for reference. I'm not sure we've ever had another member who has gone through this. I'm sure most surgeons would recommend a tissue valve for those who want children. I remember before this forum was ever established and after I went through my surgery, meeting a young woman in her twenties who specifically received a tissue valve (cadaver valve, I believe) so that she could have children. There is another member, Christian, whose wife had a valve repair after she had their first child. You may want to reference some of his old posts as well.

Best of luck to you, Kim, and continue to keep us informed as to your progress.

http://valvereplacement.com/forums/showthread.php?t=16258
http://valvereplacement.com/forums/showthread.php?t=16186
 
Speaking of Willow and Anthony ... I have been wondering how they are doing and how the pregnancy is going. I PM'd them a few weeks ago and haven't heard back nor seen a post from either in a long time.

Sorry... I think this is called thread hijacking... didn't mean to do it but the mention of Willow & Anthony made me wonder about them again. Anyone heard from them?

Kim, best of luck to you, I can offer no advice on this. However, I can say that your little daughter is beautiful!!!
 
Hi Kim,
I haven't had any more kids yet, but chose a tissue valve so that I can have more kids too. You can PM me if you have any more questions about this. good luck!
 
I just wanted to mention that I got a tissue valve last December in the hopes to have children also. I have none yet and was told by my cardiologist that he preferred me to wait a year after my surgery before trying to get pregnant. So I'm hoping we'll be able to start trying around Jan. 2007 or so. PM me if you would like to talk. I've been interested in talking to other females in my same position also.

Carista
 
Conception after Surgery

Conception after Surgery

Hello, This is Alli, I am Tony's wife(7toneMonte). He will be having a valve replacementsurgery soon enough and he has choosen a mechanical valve. My question is how will it( Cumedian-spelling??) affect HIS fertiliy, because we would like to have another child as well with in the next year or two.Thanks everyone,, this web-site has been wonderful for the both of us. Good luck to you all
Alli
 
As far as I understand, it shouldn't have any impact on his fertility. But I'll let others weigh in.
 
Consider confounding factors

Consider confounding factors

kimfusca said:
Hello Everyone,
I was wondering if anyone out there has been in a similar situation as me, and how it worked out. Any more kids? Good experience or not?


Dear Kim,

I don't have a complete perspective yet, because I am only 21 weeks pregnant. So I can't say that I've been through this and all turned out well. So far, my baby girl is perfect. I have a mechanical valve which we chose partly because it appeared that I couldn't have more children and as I was approaching 40, we didn't consider that perimenopause could be related to my heart health.

But everything got healthier after my surgery. When I found myself pregnant, we couldn't bring ourselves to terminate. I switched from coumadin to lovenox at 4 weeks and I see a hematologist from Georgetown University as well as a high-risk OB. They both say this: because of my overall health -- no overweight, no diabetes, no other heart issues, and most of all because my valve is in the aortic position, I am at the low-risk end of a high risk group. In the US, there are no documented thrombo-embolic events in pregnant anti-coagulated women with mechanical aortic valves in the last 30 years. Women with mechanical mitral valves run higher risks of that and women with confounding health factors run additional risks of different adverse events.

I don't regret my mechanical valve and I would choose it again because frankly, for me, a failing heart valve is the scariest thing that ever happened. This pregnancy is easier than my last because now my heart works.

If I were in your position, I would talk with a doctor who is experienced with pregnancy and anti-coagulation and I would talk with him/her and get expert advice about your personal situation. Inevitable failing valve (tissue) and a second valve replacement are serious risks that I'm not sure always outweigh the risk of an anticoagulated pregnancy with an aortic valve. The problem is a lack of data for making an informed decision. The FDA hates to do studies on pregnant women taking drugs because of the potential for law suits. But there are doctors out there who deal with it every day and know a lot about it. They could help you weigh your own situation.

Best of luck to you, with your heart, and your family!

Karen
 
Wow, Karen, I just read your post. My best wishes to you and your husband as you progress through this pregnancy. It sounds like you are doing very well and are being watched very closely by your specialists. Those of us females who had valve surgery during our childbearing years certainly identify with what you're going through. Please keep us informed. :) :)
 
My child was just about your daughters age when I had my MVR. Went with the mechanical valve as I was informed the tissue valves have 5/10 year life span. Maybe even shorter in yonger patients. It was a difficult choice. Went with the possibility of longevity vrs another child. Just could not handle the stress of a redo with a young one to take care of. Good news is. She is now ten. Happy, well adjusted...and spoiled:D. My valve is holding up just fine. I am very active. Zero restrictions.

Take care. All the best to you in your decision process.

PS. Let me add. If I did not have a child prior to my MVR. I would have chanced the tissue.
 
Karen-
I certainly wish you the best as you go through your pregnancy and hope everything works out as planned. One thing that needs to be considered is the effect of an anti-coagulated pregnancy on the child, not just the mother. I typed "warfarin and birth defects" into Google and came up with a ton of matches. I read the first five or so (warfarininfo.com was actually the first), and it seems pretty risky.
 
MikeHeim said:
Karen-
I certainly wish you the best as you go through your pregnancy and hope everything works out as planned. One thing that needs to be considered is the effect of an anti-coagulated pregnancy on the child, not just the mother. I typed "warfarin and birth defects" into Google and came up with a ton of matches. I read the first five or so (warfarininfo.com was actually the first), and it seems pretty risky.

The issue of birth defects is the reason that pregnant women who require ACT and take Coumadin are switched to Lovenox for the first trimester.

Karen, are you on Lovenox throughout your pregnancy, or will they switch you back to Coumadin at some point. I'm guessing since you're 21 weeks, you're on Lovenox throughout. I've also heard that sometime women are again switched to Lovenox for the 3rd trimester (if they are switched back to coumadin after the 1st.) and in this case, it would be so that the coagulation level can get back to normal quickly if deliver, or a bleeding problem arises. Or at least that is my understanding.

Karen, keep us up to date with your progress. First of all - we care! :D Secondly, I know there are a lot of women who would benefit from your experiences.

God bless!
 
Thank you, Karlynn & Sherry. It is nice to have cyber friends and I will let everyone know how this all turns out. I dream of posting a picture of my baby in November but at this point, I'm not confident enough to buy baby clothes or anything related.

I will be on lovenox for the duration and will have a scheduled cesaerean (my choice) at 38 weeks to minimize time off the anticoagulation.

There was never really any question of taking coumadin during this pregnancy because the risks of thrombo-embolism in a woman with a mechanical aortic valve are considered lower (even though they are somewhat undetermined) than the risk of birth defects. I believe my OB & hematologist would have made a different choice if I had a mechanical mitral valve but I'm not sure.

Anyway, thanks again.
 
I can't contribute any info about tissue valves and pregnancy (just the wife of AVR pt!), I only wanted to say a quick Congrats to Karen, and good luck baby wishes to Kim and Carista! We will be having alot of babies coming our way adding in Karlynn's impending Grandbaby and Christina's possible adoption! How exciting!
 
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