Key result
PTMC achieves ~97% procedural success in pregnant women with critical mitral stenosis.
Why the study?
Percutaneous transvenous mitral commissurotomy is an effective and recommended treatment for critical rheumatic mitral stenosis during pregnancy, prompting an evaluation of maternal and fetal outcomes.
Does percutaneous transvenous mitral commissurotomy improve maternal and fetal outcomes in pregnant women with critical mitral stenosis?
Observational (n=70)
No
Does percutaneous transvenous mitral commissurotomy improve maternal and fetal outcomes in pregnant women with critical mitral stenosis?
Percutaneous transvenous mitral commissurotomy is safe and efficacious for managing pregnant women with critical mitral stenosis, significantly improving clinical symptoms and echocardiographic parameters.
Answers are grounded in this paper and cite their sources.
PTMC achieved high procedural success with maternal gains in this cohort; Level 3 data leaves open net fetal benefit and should not yet change practice.
BACKGROUND: Rheumatic mitral stenosis is the common valvular heart disease seen during pregnancy. Percutaneous transvenous mitral commissurotomy is an effective, safe, and recommended treatment for critical mitral stenosis during pregnancy. We hereby report the maternal and fetal outcomes of pregnant women subjected to percutaneous trans- venous mitral commissurotomy at our institute. METHODS: Seventy consecutive pregnant women with critical mitral stenosis, who under- went PTMC during the last 10 years, were retrospectively analyzed. All patients had a detailed clinical and obstetric evaluation and were optimally managed with drugs, before the intervention. A comprehensive pre- and post-percutaneous transvenous mitral commissurotomy transthoracic echocardiographic evaluation was performed. Detailed obstetric and fetal outcomes were noted at the time of delivery. Six weeks of post-partum follow-up was noted in all patients. RESULTS: The mean gestational age at the time of percutaneous transvenous mitral com- missurotomy was 29.5 ± 6.68 weeks. Percutaneous transvenous mitral commissurotomy was successful in 97% of patients. Post-percutaneous transvenous mitral commissurot- omy New York Heart Association functional class, mitral valve area, trans-mitral pres-sure gradient, and left atrial pressure had a significant improvement (P < .001). The mean gestational age at the time of delivery was 36.92 ± 3.02 weeks. The mean birth weight of live newborn was 2.29 ± 0.55 kg. The fetal complications include growth restriction in 62.85%, preterm delivery in 34.37%, and low birth weight in 67.21%. A delayed percutane- ous transvenous mitral commissurotomy at about 30 weeks of gestation did not affect the maternal and fetal outcomes. CONCLUSION: Percutaneous transvenous mitral commissurotomy is safe and efficacious in managing pregnant women with critical mitral stenosis. There was a significant improve- ment in clinical symptoms and echocardiographic parameters following percutaneous transvenous mitral commissurotomy.
No takes yet. Share an insight, caveat, or question.
Vijayvergiya et al. (2022) conducted an observational in Critical mitral stenosis during pregnancy (n=70). Percutaneous transvenous mitral commissurotomy (PTMC) vs. Baseline (pre-intervention) was evaluated on Procedural success (mitral valve area increase >50% or ≥1.5 cm2 without severe mitral regurgitation). Percutaneous transvenous mitral commissurotomy was successful in 97.14% of pregnant women with critical mitral stenosis, yielding significant improvements in mitral valve area and functional class.
Synapse has enriched 10 related papers. Consider them for comparative context: