Patients with mechanical heart valves (MHV)s require life long anticoagulation to prevent throm boembolic complications (TECs). Women with MHVs in pregnancy experience an increased risk of severe maternal morbidity and mortality from both thrombotic and bleeding complications. A large international registry of pregnancies with MHVs revealed that valve thrombosis and maternal mortali ty occurred in 4,7 % and 1,4 % of women, respectively, and hemorrhage complicated 23 % of pregnancies [1]. Of importance, only 58 % of women with MHVs were free from serious adverse events during preg nancy compared with 79 % of women with bioprosthetic valves and 78 % of women with cardiac disease and no prosthetic valves [1].

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