girlfriend has aortic stenosis... please help

[tomcat2002]

Hello,

My girl friend, age 24, has congenital aortic stenosis. She had all the regular tests done in october 2006 where it was found that her Doppler Mean pressure gradient is 50mm HG and peak pressure grad. is 78mm HG. She does not have any symptoms and the cardiologist graded her disease as moderate aortic stenosis. She does not have any other valve related or any other heart disease. We want to get married and have children. Please let let me know about the following:

1. Will she able to have an uneventful pregnancy ?
2. If pregnancy will carry a lot of risk then can we depend upon ballon dilatation procedure to ensure her safety during pregnancy (we want to delay AVR as far as possible) ?
3. Should she go for balloon dilatation before entering into prenancy to reduce risk as far as possible ?
4. Assuming that she undergoes successful balloon dilatation procedure then how many years till she has to go for AVR ?



Gaurav
Delhi, India

[jaydam]

The concern with Aortic stenosis over time is the enlargement of the left ventrical wall of the heart....when the heart is working 2, 3 4 times the amount of a regular heart the increased load load leads to long term problems....she needs to see a specialist who can monitor her condition over time....as a moderate she may be years before she will need surgery...the usual test is a yearly or every 6 month echocardiogram to detect changes... even if she requires surgery she will still be able to have children if she chooses a biological valve replacement as opposed to mechanical.....with a mechanical valve you must go on blood thinners to avoid clots forming....this would prevent her from having children as it would make pregnacy too dangerous....

[Caper24]

Honestly, these questions should be put to her cardiologist.  As jaydam said, her condition needs to be monitored over time and changes can occur drastically. I've gone from severe to critical stenosis in a matter of months for example.  As i'm the same age as your gf, I've discussed possible pregnancy issues with my cardiologist.  Generally,  a pregnancy requires careful planning with someone with stenosis.Pregnancy is known to be easier for a person with a homograft valve rather than a mechanical valve. I've been told it is possible to carry a child with a mechanical but it requires special medical attention.  Get your gf to discuss childbearing with her cardiologist and get a medical opinion.