Key result
Percutaneous trans-luminal mitral commissurotomy in pregnant women with severe mitral stenosis increased mitral valve area from 0.83 to 1.38 cm2.
Why the study?
Does percutaneous trans-luminal mitral commissurotomy improve mitral valve hemodynamics and maintain safety in pregnant women with severe mitral stenosis?
Observational (n=33)
Does percutaneous trans-luminal mitral commissurotomy improve mitral valve hemodynamics and maintain safety in pregnant women with severe mitral stenosis?
PTMC is effective and safe for managing severe mitral stenosis during pregnancy, significantly improving valve hemodynamics without major maternal or fetal adverse events.
Answers are grounded in this paper and cite their sources.
Supports PTMC consideration in pregnant severe MS; leaves open need for randomized confirmation of safety and outcomes.
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 ± 0.13 cm(2) to 1.38 ± 0.29 cm(2) (P = 0.007). Mean gradient of mitral valve decreased from 15.5 ± 7.4 mmHg to 2.3 ± 2.3 mmHg (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.
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Abdi et al. (2012) conducted an observational in Severe mitral stenosis in pregnancy (n=33). Percutaneous Trans-Luminal Mitral Commissurotomy (PTMC) vs. Baseline (pre-procedure) was evaluated on Mitral valve area (cm2) (p=0.007). Percutaneous trans-luminal mitral commissurotomy in pregnant women with severe mitral stenosis increased mitral valve area from 0.83 to 1.38 cm2.
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