Heart Team Approach for Cardiogenic Shock Management in Pregnancy Complicated by Mechanical Mitral Valve Thrombosis

Ritu Yadav; Arune A Gulati; Karan Kapoor; Katelyn Uribe; Allison G Hays; Eunjung Choi; James S Gammie; Hanghang Wang; Minhal Makshood; Arthur J Vaught; Anum S Minhas

doi:10.1016/j.jaccas.2023.102107

Heart Team Approach for Cardiogenic Shock Management in Pregnancy Complicated by Mechanical Mitral Valve Thrombosis

JACC Case Rep. 2023 Dec 6:27:102107. doi: 10.1016/j.jaccas.2023.102107.

Authors

Affiliations

¹ Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
² Lehigh Valley Heart and Vascular Institute, Allentown, Pennsylvania, USA.
³ Heart and Vascular Institute, Temple Health, Philadelphia, Pennsylvania, USA.
⁴ Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA.
⁵ Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁶ Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
⁷ Division of Acute Care and Adult Trauma Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.

Abstract

A 27-year-old pregnant woman at 24 weeks of gestation was admitted with cardiogenic shock due to mechanical mitral valve thrombosis. Following discussion with the heart team, thrombolysis was achieved with tissue plasminogen activator therapy followed by heparin infusion. Ultimately, the patient required mitral valve replacement for persistently elevated gradients.

Keywords: cardiogenic shock; mechanical valve thrombosis; mitral valve stenosis; thrombolysis.

Publication types

Case Reports