Dr. Yihan Lin receives funding to study maternal and fetal outcomes in Rwandan women with mechanical heart valves

by Roxanna Van Norman
January 25, 2024

Yihan Lin, MD, MPH, a clinical assistant professor in the Department of Cardiothoracic Surgery at Stanford School of Medicine, has been awarded a Clinician Educator (CE) Award from the Stanford Maternal and Child Health Research Institute to support her project on maternal and fetal health outcomes in low-income countries.

The CE Grants Program, which supports Dr. Lin's work, encourages faculty to pursue impactful and meaningful clinical research for the proposed project. Dr. Lin's project, titled "Maternal and Fetal Outcomes in Rwandan Women with Mechanical Heart Valves," addresses a critical healthcare challenge among women in Rwanda who have mechanical heart valves and face potential high-risk pregnancy outcomes.

In low- and middle-income countries (LMICs), rheumatic heart disease remains the largest burden of cardiovascular disease. Typically, patients are diagnosed in the advanced stage of the disease. Where surgical valve replacement is the only possible intervention, mechanical valves are often the valve of choice due to limited resources.

This places a significant burden on female patients of childbearing age, as anticoagulation with Warfarin – a blood-thinning agent – poses risks to fetal development and may result in pregnancy complications for patients with already compromised cardiac function.

With this in mind, women are typically advised against pregnancy at the time of their surgery. Despite the high risk to themselves and their fetuses, social stigma and the desire for children often become overwhelming, and many decide to move forward with the pregnancy.

Focusing on Rwanda, a low-income country in Sub-Saharan Africa, Dr. Lin's research aims to (1) quantify the burden and outcomes of pregnancy among women with mechanical heart valves and (2) share these results with local providers and stakeholders to establish a consensus on patient practice guidelines. She and her research team hope that findings from this study will not only improve patient outcomes but also inform policy decisions in Rwanda and other LMICs in the region.

Dr. Lin is a cardiothoracic surgeon at Stanford Medicine. She provides the complete spectrum of surgical care for cardiac conditions, including ischemic heart disease, structural heart disease, aortic disease, and arrhythmias. Her research focuses on surgical education and global disparities in surgical care, including in low- and middle-income settings.