Valve Choice in Young Female with Rheumatic Mitral Stenosis MCQ
Clinical Scenario: A 28-year-old woman with rheumatic mitral stenosis requires valve replacement. She wishes to become pregnant.
Best valve choice?
A. Mechanical mitral valve
B. Bioprosthetic mitral valve
C. Ross procedure
D. Mitral valve repair is contraindicated
Correct Answer: B. Bioprosthetic mitral valve
Explanation:
- Mechanical valves require lifelong anticoagulation → high maternal/fetal risk during pregnancy
- Bioprosthetic valves degenerate faster in young patients, but pregnancy safety takes priority
Teaching Points:
- Valve choice is patient-context driven
- Pregnancy is a strong relative contraindication to mechanical valves
- Future valve-in-valve procedures are now feasible
- Always involve the patient in shared decision-making