Key result
Percutaneous mitral commissurotomy in pregnant women with severe mitral stenosis significantly increased mitral valve area from 1.01 cm2 to 2.01 cm2 (p < 0.001) and resulted in favorable long-term maternal and fetal outcomes.
Why the study?
Does percutaneous mitral commissurotomy improve clinical outcomes and allow for normal fetal development in pregnant women with severe mitral stenosis?
Observational (n=15)
No
Does percutaneous mitral commissurotomy improve clinical outcomes and allow for normal fetal development in pregnant women with severe mitral stenosis?
Percutaneous mitral commissurotomy is a safe and effective procedure for pregnant women with severe rheumatic mitral stenosis, providing excellent long-term maternal outcomes and normal childhood development.
Answers are grounded in this paper and cite their sources.
Supports percutaneous mitral commissurotomy in pregnant women with severe mitral stenosis; leaves open need for randomized confirmation of outcomes.
Background: Percutaneous mitral commissurotomy (PMC) can be safely performed during pregnancy.However, there is still little known about follow-up results after PMC in populations of pregnant women taking into consideration childhood development.Aim: To evaluate long-term clinical follow-up and echocardiographic data on pregnant patients who underwent PMC in our centre and development of their infants.Material and methods: From January 1989 to December 1998, 15 pregnant women with mitral stenosis and severe congestive heart failure (mean gestational duration, 31.5 ±2.7 week) underwent PMC.The procedure was successful in all patients, resulting in a significant increase (0.85 ±0.3 cm 2 ) in mitral valve area from 1.01 ±0.24 cm 2 to 2.01 ±0.33 cm 2 (p < 0.001) and New York Heart Association (NYHA) improvement to class I or II (13 and 2 patients respectively).Results: There was no maternal death, no abortion, no intrauterine growth restriction, and no stillbirth.One baby (6.6%) had cerebral palsy at birth.Long term follow-up of 17 years and 9 months was completed for 12 patients.Two patients (13%) underwent re-PMC, and one (6.6%)surgical mitral valve replacement 15, 17 and 19 years after the first procedure, respectively.All babies maintained normal growth and development without any clinical abnormalities, thyroid disease or malignancy.Conclusion: PMC is a safe and effective procedure, with favourable long-term results in the population of pregnant women with rheumatic mitral stenosis and severe congestive heart failure.
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Dąbrowski et al. (2011) conducted an observational in Mitral stenosis and severe congestive heart failure in pregnancy (n=15). Percutaneous mitral commissurotomy vs. Baseline (pre-procedure) was evaluated on Mitral valve area (cm2) (p=<0.001). Percutaneous mitral commissurotomy in pregnant women with severe mitral stenosis significantly increased mitral valve area from 1.01 cm2 to 2.01 cm2 (p < 0.001) and resulted in favorable long-term maternal and fetal outcomes.
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