Mechanical Mitral Valve Replacement during the 2nd Trimester of Pregnancy

Cardiac implant and the risk of infective endocarditis in pregnancy

Objectives

Infective endoplastitis/endocarditis (IE) due to a cardiac implant is an extremely rare event during pregnancy. Management and prognosis is not well known in this population.

Case presentation

A 29-year-old woman, gravida 1 para 0, at 19 3/7 weeks gestation with an Amplatzer septal occluder presented to the hospital with fever. A transesophageal echocardiogram demonstrated cardiac vegetations. She subsequently underwent cardiopulmonary bypass surgery with fetal monitoring to remove the device and eventually went on to deliver a full-term infant.

Conclusions

IE should be on the differential in patients with cardiac device. Multidisciplinary efforts enable prompt initiation of treatment after weighing the risks and benefits to both mother and fetus. Lastly, the fetal status can be utilized to assess for hemodynamic status of the mother.