Balloon Mitral Valvotomy in Gestational Women with Symptomatic Mitral Stenosis
Prem Krishna Anandan
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
Arun Kaushik *
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
K. Tamilarasu
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
G. Rajendran
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
Shanmuga Sundaram
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
P. Ramasamy
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
R. B. Vidyakar
Department of Cardiology, PSG Hospitals, Peelamedu, Coimbatore, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Rheumatic valvular heart disease, commonly mitral stenosis, complicate 1% of pregnancies. Balloon mitral valvuloplasty (BMV) is an established treatment of rheumatic mitral stenosis. Aim of the study was to assess the safety and efficacy of Balloon mitral valvuloplasty in pregnant women with severe mitral stenosis.
Materials and Methods: 66 patients who failed to respond to medical therapy undergoing BMV during pregnancy were analysed in this retrospective study. Mitral valve area (MVA), transmitral Mean valve gradient (MVG), and mitral regurgitation (MR), Pulmonary artery pressure (PAP) were assessed before and 24 hours after the procedure by transthoracic echocardiography. Patients were followed up to one month post BMV and neonates were monitored for the adverse effect of radiation.
Results: Mitral valve area increased from 0.83 ± 0.13 cm2 to 1.38 ± 0.29 cm2 (P = 0.007). Mean gradient mitral valve gradient decreased from 15.5 ± 7.4 mmHg to 3.36 ± 2.36 mmHg (P = 0.001). Pulmonary artery pressure decreased from 65.24 ± 17.9 to 50.45 ± 15.33 (P = 0.012). No maternal death, intrauterine growth restriction was observed.
Conclusion: Balloon mitral valvuloplasty has favourable immediate good outcomes for mothers and newborns.
Keywords: Balloon mitral valvuloplasty, mitral stenosis, pregnancy.