Immediate results of percutaneous trans-luminal mitral commissurotomy in pregnant women with severe mitral stenosis

Seyfollah Abdi, Negar Salehi, Babak Ghodsi, Hossein Ali Basiri, Mahmoud Momtahen, Ata Firouzi, Hamid Reza Sanati, Farshad Shakerian, Mohsen Maadani, Homan Bakhshandeh, Soheila Chamanian, Mitra Chitsazan, Anoushiravan Vakili-Zarch

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms. PTMC is an established non-surgical treatment of rheumatic mitral stenosis. The study aimed to assess the safety and efficacy of PTMC in pregnant women with severs mitral stenosis. Material and Method: Thirty three consecutive patients undergoing PTMC during pregnancy enrolled in this prospective study. Mitral valve area (MVA), transmitral valve gradient (MVG), and severity of mitral regurgitation (MR) were assessed before and 24 hour after the procedure by transthoracic and transesophageal echocardiography. Mitral valve morphology was evaluated before the procedure using Wilkin's criteria. Patient followed for one month and neonates monitored for weight and height and adverse effect of radiation. Result: Mitral valve area increased from 0.83±0.13cm2 to 1.38±0.29cm2 (P=0.007). Mean gradient of mitral valve decreased from 15.5 ± 7.4mmHg to 2.3 ± 2.3mmHg (P=,0.001). Pulmonary artery pressure decreased from 65.24±17.9 to 50.45±15.33 (P=0.012). No maternal death, abortion, intrauterine growth restriction was observed and only one stillbirth occurred. Conclusion: PTMC in pregnant women has favorable outcome and no harmful effect on children noted.

Original languageEnglish
Pages (from-to)35-39
Number of pages5
JournalClinical Medicine Insights: Cardiology
Volume6
DOIs
StatePublished - 2012
Externally publishedYes

Keywords

  • Mitral stenosis (MS)
  • Percutaneous transluminal mitral commissurotomy (PTMC)
  • Pregnancy

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