valve replacement and pregnancy

[DASMom]

Hi! You all sound like you have lots of knowledge, so I hope you can share some with me! I am only 22, and after having my first child was just advised by my cardiologist to undergo surgery on my mitral valve. I was just wondering if any of you have gotten pregnant after a valve replacement, or whether you know anyone who has. I would like to have more children, and would like to hear from someone who knows. I have been searching for info everywhere, but am having a difficult time finding any. Thanks in advance for all your help - this website is great!!

 

[LUVMyBirman]

Hello

Welcome! This is a great site.

I was 30....had one child when my MVR was suggested as well.

Ask your surgeon about repairing your valve. Your best option with the mitral valve if you would like to become pregnant again. They usually cannot inform you of this option until day of surgery. Need to get in and take a look.

If they decdie that repairing in not an option, mechanical valves are widly used and would require anticougulation medication. Coumadin which is a blood thinner. Unfortunately, that med cannot be taken while pregnant. Though.....there have been individuals managed with heparin injections throughout the pregnancy. The statistics to carry out a sucessful pregnancy with a mechanical valve did not impress me..... so, I opted not to have additional children.

Tissue valves are an option for woman that would like to become pregnant. They do carry their own set of issues, especially since finding a surgeon that has experience placing this valve in the Mitral position would be difficult. Too controversial at this point.

It's a very personal decision. Happy with my choice and would do the same again if given the options.

 

[JenniferO]

Hi and welcome:

I am undergoing mitral valve repair in less than three weeks. Although the doctors can't say for sure what they are dealing with until they are inside your chest, they ought to be able to give you some opinion as to whether or not your valve is repairable or will have to be replaced. They can tell best from a special type of echocardiogram called a TEE where a scope is put down your esophagus just behind your heart to give a better look at the valve than just a regular thoracic echo can give. Don't be afraid of the TEE; it's not as bad as it sounds. They give you plenty of drugs so it's relatively easy.

I am past the age where child-bearing is an issue, but you might want to check out the thread started by Janice on 11/11/01 in the Post-Surgery Forum on pregnancy. Similar information to what Gina has just posted.

Jennifer

 

[Mara]

DASMom

Hi. I had aortic valve replacement--the Ross Procedure.
Before surgery the cardio said I should not get pregnant, ever!
After surgery, especially the Ross, a lot of women can have children. My cardio told me it would be "un-wise" for me to get pregnant. My gynecologist said the same.

It's not so much the being pregnant that is bad as it is the birth process where you lose a lot of fluid quickly that is the trouble. A person without a heart condition can get compromised, it can be real trouble for a woman with a heart condition.

You need to ask your cardio. Everyone is different.
I think it also has a lot to do with what kind of valve you get, too. If you get a mechanical valve, as Gina said, you can't be on coumadin. My understanding is that you have to go off that and go on heparin, this usually requires hospitalization. Don't know for how long during the pregnancy, might be most of the 9 months. You will probably have to be managed by a high-risk pregnancy ob/gyn. There are a lot issues regarding medications during pregnancy. Plus, you might not "bounce back" from the birth as quickly.

For me, the risks are too great. I don't want to jeopardize my surgery. I was 33 when I had my surgery.
If there are kids out there for my husband and I we'll find them.
But, your situation might be totally different. Only you and your docs can get to the answers! It's a hard situation. Good Luck!

-Mara

 

[ShanaleT]

DASMom

I am 26 and have a little boy who is 3 1/2. The difference between you and me is that I had my aortic valve replaced. I researched the pregnancy issue for about 6 months before I had surgery because I felt like there had to be a way. Unfortunately, the odds were not good enough for me to attempt another pregnancy before the surgery, nor after because of the Coumidin. I really wanted to have a tissue replacement at the time I talked to the surgeon because that would have enabled me to have another baby and then I could have another replacement in a few years when that wore out. My doc would not do it because I also had an enlarged aortic root that needed to be replaced. I guess the point of this is that I am finally resolved with my decision. I am glad that I got the mechanical valve since I cannot imagine going through the surgery again. I am not sure what I expected, but it was harder than I ever thought it would be. You are in my prayers because I know that for me this was one of the hardest decisions of my life as I am sure it is yours. Good luck.

Shana

 

[Tammy]

Hi Dasmom,

I have to concur with the others. Although not impossible, I wouldn't recommend it (getting pregnant) as I doubt any of your Doctors would.

I had 2 children prior to surgery and the 2nd birth was too much for my already damaged valve to take. I had my mitral valve replaced 6 months after she was born.

Remember - you can always adopt if you have your heart set on having more children. The main thing right now is to get yourself taken care of and the rest will fall in place.

I wish you the best of luck.

Hi Shana - How are you? Send me an e-mail or give me a call. They finally got my phone hooked up last week.

Tammy

MVR
04/06/89

 

[deborahj]

I might be really out of line here, but when i was told that I needed surgery (for avr tho) my consultant said that it was possible to get pregnant and give birth with a mechanical valve but that there were numerous risks and that it would involve very careful management, changing in from warfarin to heparin. He did not say it was not possible.
Secondly, I was 7 mnth pregnant when I realised i needed a valve replacement, but actually had it almost 2 years on from that, and went through an easy ( if scary for me) pregnancy and a 3 hour long natural birth.. What timescale are the docs talking of for your mvr?If you were pregnant now what would the prognosis be, how would they manage your care?I think these questions might be good to ask.i thought the link below might be interesting as an overview...but you may well have seen it already...Anyway, Big love and xxx's from London
debs


http://www.dencats.org/heart/preg/pregsurg.htm
http://www.merck.com/pubs/mmanual/section18/chapter251/251b.htm

 

[DASMom]

Thank you all for your replies. It is encouraging to know that I am not the only one with this problem out there! I just spoke with the surgeon yesterday, and he wants to do the surgery in late spring/early summer. He said he is going to try as hard as he can to repair the mitral valve, but if he can't he will replace it with a tissue valve which will enable me to have more children. Obviously, the problem with that is the fact that I will have to undergo another surgery. Can any of you imagine having surgery twice? He also mentioned the possibility of a human valve, but did say that in the mitral position it is risky business.
Thanks for all your replies!!
DA'S Mom

 

[Nancy]

Hi DASmom-

My husband has had 3 open heart valve surgeries, plus 2 lung surgeries. Each one was difficult, but it is do-able. Just have to grit your teeth and go through with it. He didn't have choices. It was a survival deal.

Best wishes to you. I hope they can repair your valve.

 

[Hank]

Even Hank has a comment for DASMom!

Even Hank has a comment for DASMom!

Hello DASMom,

First of all, the act of bringing children into this world is in my opinion the single greatest purpose for us being on this planet. It is admirable for you to want your surgical process such that it allows you to have children in the future.

I cannot even imagine how difficult such a decision would be. I, being male, did not have to make such a decision. You women do all the hard jobs and for that we are grateful. (at least I am).

The thought of having surgery again makes my bones shudder and my sternum throb with pain

However, I believe if I were in your position, I would have tissue valve replacement with whatever tissue valve offers the most longevity. Science is progressing rapidly and there is always a chance that a process will be inplace to keep that valve going forever.

And last but not least, If I had to have open heart surgery in order to have each and every child of mine, then I would have GLADLY had four surgeries already. And I would also have the surgery again if it was required to have another child.

I don't know if I am making any sense, but to make a short story long, I believe childbirth is the single thing that would make a tissue valve the best choice for you.

Only my humble opinion to hopefully aid you in your difficult decision making process

 

[Peachy]

Hi DASMom

If you want to have more children in the future then a tissue valve is your only option. Unfortunately this will only last 10 to 15 years and another surgery is inevitable. With each surgery the risk doubles. You have to decide what is more important, having more children or having a mechanical valve which should "last a lifetime" and having to take bloodthinners for the rest of your life. It really is a case of where your priorities lie. Anything is possible but decisions have to be made. A resurgery is by no means a small thing but you can always take comfort in the fact that you already have a child.

 

[Christina]

Dear DasMom,

A second surgery is always possible, even with a mechanical valve. We just never know what can happen!
I had to have a second AVR 11 days after my first because of a blood clot. My INR was not stable yet, and kept too low. (Read my personal story)
A second surgery was not fun to say the least! I was very afraid again, and I could tell from my husband's and daughter's faces that they were afraid too.
I am now 17 months post-op from my 2nd AVR and DON'T EVER want to do this again.
I know there are many people on the forum that are afraid of having to take Coumadin for the rest of their lives, but I find that nothing compared to having my chest opened again.

Wishing you all the best!

Christina
Aortic Stenosis
AVR's 8/7/00 & 8/18/00
St.Jude's Mechanical

 

[McCln]

DasMom

DasMom

I also had six months to make a decision. But living outweighed the choice of having childredn and had mechanical valve replacement. Being on coumadin is not the end of the world. I have no children, so be happy with what you do have. I am single and sometimes sad that I have no children, but can adopt whenever I do get married. You do whatever you feel comfortable with. Get the tissue if you want more children, get the mechanical if you are ready to not have more children. It is a hard decision to make. I know it was for me, at 36 years of age. But I am not completely sad over it. There are more children that we can give attention to. Be brave and strong and welcome. You are going to be alright.

Caroline
09-13-01
Arotic valve replacement
St. Jude's valve