Prosthetic Valves in Pregnancy: Difference between revisions
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Dima Nimri (talk | contribs) (Created page with "__NOTOC__ {{CMG}}; {{AE}}{{DN}} ==Prosthetic Valves in Pregnancy<ref name="pmid24603192">{{cite journal |vauthors=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guy...") |
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===Diagnosis and Follow-up=== | ===Diagnosis and Follow-up=== | ||
{|class="wikitable" style="width:80%" | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' All patients with a prosthetic valve should undergo a clinical evaluation and baseline TTE before pregnancy.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' All patients with a prosthetic valve should undergo pre-pregnancy counseling by a cardiologist with expertise in managing patients with VHD during pregnancy.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' TTE should be performed in all pregnant patients with a prosthetic valve if not done before pregnancy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Repeat TTE should be performed in all pregnant patients with a prosthetic valve who develop symptoms.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' TEE should be performed in all pregnant patients with a mechanical prosthetic valve who have prosthetic valve obstruction | |||
or experience an embolic event. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''6.''' Pregnant patients with a mechanical prosthesis should be monitored in a tertiary care center with a dedicated Heart Valve Team of cardiologists, surgeons, anesthesiologists, and obstetricians with expertise in the management of high-risk cardiac patients.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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|} | |||
===Medical Therapy=== | ===Medical Therapy=== | ||
Revision as of 22:14, 27 October 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Prosthetic Valves in Pregnancy[1]
Diagnosis and Follow-up
| Class I |
| "1. All patients with a prosthetic valve should undergo a clinical evaluation and baseline TTE before pregnancy.(Level of Evidence: C)" |
| "2. All patients with a prosthetic valve should undergo pre-pregnancy counseling by a cardiologist with expertise in managing patients with VHD during pregnancy.(Level of Evidence: C)" |
| "3. TTE should be performed in all pregnant patients with a prosthetic valve if not done before pregnancy. (Level of Evidence: C)" |
| "4. Repeat TTE should be performed in all pregnant patients with a prosthetic valve who develop symptoms.(Level of Evidence: C)" |
| "5. TEE should be performed in all pregnant patients with a mechanical prosthetic valve who have prosthetic valve obstruction
or experience an embolic event. (Level of Evidence: C)" |
| "6. Pregnant patients with a mechanical prosthesis should be monitored in a tertiary care center with a dedicated Heart Valve Team of cardiologists, surgeons, anesthesiologists, and obstetricians with expertise in the management of high-risk cardiac patients.(Level of Evidence: C)" |
Medical Therapy
References
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J. Am. Coll. Cardiol. 63 (22): 2438–88. doi:10.1016/j.jacc.2014.02.537. PMID 24603192.