The course of pregnancy in patients with artificial heart valves treated with dipyridamole

Continuing improvements in cardiac surgery and a wider selection of young patients for prosthetic valve replacement mean that an increasing number of women of childbearing age will undergo such procedures and will also subsequently become pregnant. At present, most patients with prosthetic heart valves are treated with anticoagulant drugs for life. The main problem with anticoagulant therapy during pregnancy is fetal and maternal hemorrhage. Congenital anomalies have been described born to mothers treated with coumarin derivatives during the first trimester of pregnancy. Dipyridamole is known to decrease the adhesiveness of platelets or their ability to aggregate. We report the successful outcome of four pregnancies in patients with Starr-Edwards prostheses who were treated with dipyridamole during their pregnancies.