Abstract
This report describes a therapeutic alternative for correction of severe mitral stenosis causing high-response atrial fibrillation, and consequent syncope in a woman at 8 weeks gestational age. A percutaneous valvuloplasty attempt failed, because the transseptal puncture was not possible, and a definitive resolution was achieved by transapical valvuloplasty, via left thoracotomy through an inframammary incision, with direct access to the mitral valve. Since this was an original and complex procedure, this case is of relevant importance in the treatment of severe mitral stenosis in patients whose conditions render a conventional procedure impossible.
Highlights
Rheumatic mitral stenosis is the most frequently found valve pathology in pregnant women.[1]
The condition tends to worsen during pregnancy, due to increased cardiac output and heart rate.[2]
The opposite is true: among systemic thromboembolic events in pregnancy, 80% occur in patients with atrial fibrillation.[9]
Summary
Transapical valvuloplasty for correction of severe mitral stenosis with arrhythmic repercussion in a pregnant woman: case report. Valvoplastia transapical para correção de estenose mitral grave com repercussão arrítmica em gestante: relato de caso. A percutaneous valvuloplasty attempt failed, because the transseptal puncture was not possible, and a definitive resolution was achieved by transapical valvuloplasty, via left thoracotomy through an inframammary incision, with direct access to the mitral valve. Since this was an original and complex procedure, this case is of relevant importance in the treatment of severe mitral stenosis in patients whose conditions render a conventional procedure impossible. RESUMO – Este relato descreve uma alternativa terapêutica para a correção de estenose mitral grave determinante de fibrilação atrial de alta resposta e consequente síncope em gestante de 8 semanas.
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