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Dabigatran Renal Dose Adjustment — EECC MCQ

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HardArrhythmia & ElectrophysiologyDabigatran Renal Dose AdjustmentEECC

A woman with a mechanical mitral valve wishes to become pregnant. Which statement is most accurate?

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Correct answer: DPre-conception planning by a pregnancy Heart Team

No regimen eliminates both maternal and fetal risk. Vitamin K antagonists provide strong valve protection but carry embryopathy and fetal bleeding risks, while heparin regimens require strict weight-adjusted dosing and monitoring and may have more valve thrombosis. Pre-conception planning in an expert pregnancy Heart Team is therefore essential. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: 2025 ESC Guidelines on cardiovascular disease and pregnancy. https://www.escardio.org/guidelines/clinical-practice-guidelines/cardiovascular-disease-during-pregnancy/