Above: Patient Andrea and Her Son Anthony, with Dr. Candice Silversides
Andrea Querido has never been a quitter. Born in 1976 with an abnormal heart valve, she underwent multiple surgeries, including the insertion of a mechanical heart valve at the age of nine. Andrea lived to her 30s believing her heart condition meant she might never have children. Yet she always held out hope.
When Andrea and her husband Armindo learned about Mount Sinai’s internationally renowned Pregnancy and Heart Disease Program, their hope grew into optimism. It wasn't easy, but Andrea gave birth to a healthy baby boy in April 2014.
Today, their son Anthony is a chatty, superhero-loving preschooler. “He’s thriving,” says Andrea.
Pregnancy places enormous demands on the body and the heart especially. Women like Andrea with a mechanical heart valve are at greater risk of developing potentially life-threatening blood clots. But two decades of research, including important studies by Andrea’s own cardiologist, Dr. Candice Silversides, have contributed to making pregnancy safer for women with high-risk heart conditions.
This paradigm-shifting research includes an influential 2001 national study led by Mount Sinai researchers that enrolled 600 women from across Canada, and led to the development of the first “risk score” that predicts the likelihood of heart complications during pregnancy. “The risk score helps us figure out who is at serious risk for complications during pregnancy and how we should best tailor their care to prevent them,” says Dr. Silversides, who is also a clinician-scientist at the Lunenfeld-Tanenbaum Research Institute.
Three years before Andrea and Armindo tried to conceive, she met with Dr. Silversides to discuss how she might have a healthy pregnancy. Dr. Silversides described several steps Andrea would need to take before and during pregnancy. One of these included switching Andrea from her regular blood-thinning medication during pregnancy, which would have been unsafe for the baby, to an injectable blood thinner called Fragmin. A 2009 study by Dr. Silversides and Mount Sinai colleagues was among the first in the world to show that Fragmin could be used safely in women with mechanical heart valves during pregnancy. “Our study proved that Fragmin was safe for both mom and baby, and it outlined a treatment and monitoring protocol,” says Dr. Silversides.
Andrea visited Mount Sinai weekly during her pregnancy to meet with members of her multidisciplinary care team, which included Dr. Silversides and her high-risk obstetrician Dr. Mathew Sermer, Dr. Nadine Shehata, a hematologist, and others.
“I can’t rave enough about Mount Sinai,” Andrea says. “Dr. Silversides is always striving to provide the best care for pregnant women with heart disease."