Key result
Percutaneous mitral commisurotomy was performed in two pregnant women with severe mitral stenosis, highlighting the importance of retaining these procedural skills.
Why the study?
Percutaneous mitral commisurotomy during pregnancy is rarely performed in the United Kingdom due to low incidence of rheumatic heart disease and planned interventions before pregnancy.
Case Report (n=2)
No
Highlights the feasibility and importance of retaining skills for percutaneous mitral commisurotomy in pregnant patients with severe mitral stenosis in regions with low rheumatic heart disease incidence.
May support percutaneous mitral commissurotomy in select pregnant women with severe mitral stenosis; leaves open need for larger prospective safety data.
We report two cases of severe mitral stenosis where percutaneous mitral commisurotomy was performed within pregnancy. The first case involves an emergency procedure for a new diagnosis of severe mitral stenosis in a woman presenting with pulmonary oedema at 27 weeks' gestation. The second case is of a woman known to have mitral stenosis who underwent a semi-elective procedure for deterioration in symptoms. This procedure is not commonly performed in the United Kingdom because of low incidence of rheumatic heart disease. In addition, percutaneous mitral commisurotomy during pregnancy is rarely performed in the United Kingdom because of the improved healthcare system where majority of the women with moderate to severe mitral stenosis (even asymptomatic) will undergo planned interventions (percutaneous mitral commisurotomy or mitral valve surgery) before contemplating pregnancy. These cases highlight both the acute and chronic presentations of mitral stenosis and the impact pregnancy has on this condition. In addition, these cases show the importance of retaining skills in performing percutaneous mitral commisurotomy within our United Kingdom cardiologists.
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Kapoor et al. (2015) conducted a case report in Severe mitral stenosis during pregnancy (n=2). Percutaneous mitral commisurotomy was evaluated. Percutaneous mitral commisurotomy was performed in two pregnant women with severe mitral stenosis, highlighting the importance of retaining these procedural skills.
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