Abstract
Balloon Mitral Valvuloplasty (BMV) has been performed safely during pregnancy with good results. This study was intended to see the efficacy and safety of BMW in this subset. Retrospective analysis of 22 pregnant women among a total of 861 patients who had undergone BMV for severe mitral stenosis at SGNHC from January 2003 to December 2007 were done. Mean fulroscopy time was 7.5±4.8 min. post-BMV, the mean left atrial pressure dropped from 28.12±4.3 mmHg to 15.32±6.4 mmHg. Mitral valve area as assessed by echocardiography increased from 0.76 01770.21 cm2 to 1.8±0.26 cm2. all the patients showed symptomatic improvement. Six patients had an increase in MR by 2 grades. Twenty patients had a normal delevery while 2 underwent a caesarean section. There was no meternal morbidity or mortality in the peripartum period. On follow up for 26±15 months, all babies maintained normal growth and development without any thyroid disease or malignancy. During pregnancy BMV is feasible, safe and effective. Maternal and fetal outcomes are excellent. Growth and milestone of development are not affected.
Highlights
Mitral stenosis (MS) primarily affects young women at reproductive age
Pregnancy is associated with a 40-50% increase in cardiac outpur and a decrease ib systemic vascular resistance but, in the presence of severe mitral stenosis, these changes cannot occur
Mean fluoroscopy time was 7.5±4.8 min. postBMV, the mean left atrial pressure dropped from 28.12±4.3 mmHg to 15.32±6.4 mmHg
Summary
Mitral stenosis (MS) primarily affects young women at reproductive age. Pregnancy is associated with a 40-50% increase in cardiac outpur and a decrease ib systemic vascular resistance but, in the presence of severe mitral stenosis, these changes cannot occur. The haemodynamic effects of mitral stenosis, together with the risk of thromboembolism, can lead to significanternal and fetal morbidity and mortality. For several decades surgical commisurotomy was being performed during pregnancy in patients with severe MS. BMV has been established as an effective method for treating MS in pregnancy with results comparable to surgical commisurotomy. Studies to date have shown equal efficacy of the two BMV methods in terms of valve enlargement the inoue approach is ismpler, faster, and yielded similar benefits and is associated with a lower risk of creating severe mitral regurgitation. We designed this study to evaluated the safety of BMV for the treatment of MS in pregnant women
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