Percutaneous mitral balloon valvuloplasty in pregnant women with mitral stenosis

Nercolini, Deborah Christina; Bueno, Ronaldo da Rocha Loures; Guérios, Ênio Eduardo; Tarastchuk, José Carlos Estival; Pacheco, Álvaro Luis; Andrade, Pedro; Cunha, Cristiane Martins; Germiniani, H

doi:10.1002/ccd.10225

Cited by 29 publications

(9 citation statements)

References 35 publications

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“…In current practice minimally invasive percutaneous mitral balloon valvuloplasty (PMBV) is the procedure of choice and has almost replaced the open surgical mitral valve commissurotomy 5 . Balloon mitral valvotomy has been observed to improve maternal and fetal outcome in severe MS during pregnancy1, 7, 8, 9, 10, 11. Even long term obstetric outcome and development of children born to these women has been found to be good 5 .…”

Section: Introductionmentioning

confidence: 99%

Comparative study on maternal and fetal outcome in pregnant women with rheumatic heart disease and severe mitral stenosis undergoing percutaneous balloon mitral valvotomy before or during pregnancy

Sharma

Yadav

Mishra

et al. 2018

Indian Heart Journal

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Introduction Mitral stenosis due to rheumatic heart disease is a common problem in India causing significant morbidity and mortality. We have compared the maternal and fetal outcome of women with severe mitral stenosis undergoing percutaneous balloon mitral valvotomy before or during pregnancy. Methods A total of 24 women of severe rheumatic mitral stenosis who underwent balloon mitral valvotomy before pregnancy (14 women, group 1) or during pregnancy (10 women, group 2) were included in the retrospective descriptive analysis. Results The mean age was 25.5 ± 3.6 yrs in group 1 and 25.7 ± 3.5 yrs in group 2. There was no difference in characteristics –primigravidas, time since diagnosis from pregnancy, NYHA (New York Heart Association) class and associated medical problems in the two groups. There was significant difference in cardiac events during pregnancy in the two groups. New York Heart Association class deterioration was observed in only 3(21.4% women in group 1) as compared to all (10; 100% women) in group 2(p < 0.001). The incidence of arrhythmias and atrial fibrillation was not different in two groups. Obstetric events were similar in the two groups. Mode of delivery and caesarean section rate was also similar in the two groups. There was no significant difference in mean birth weights (2399.75 ± 601.8 gm vs. 2641.70 ± 580.6 gm),rate of fetal growth restriction, still birth and congenital malformation rates in the two groups. Conclusion Percutaneous mitral valvotomy for patients with severe mitral stenosis can be safely performed during pregnancy and has equivalent maternal and fetal outcomes as that performed before pregnancy.

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Section: Introductionmentioning

confidence: 99%

Comparative study on maternal and fetal outcome in pregnant women with rheumatic heart disease and severe mitral stenosis undergoing percutaneous balloon mitral valvotomy before or during pregnancy

Sharma

Yadav

Mishra

et al. 2018

Indian Heart Journal

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“…The recent reports by Mangione et al [10], Fawzy et al [11], and Lee et al [12] all confirmed that no developmental or growth abnormalities were found in children born of mothers who underwent percutaneous balloon mitral valvuloplasty during their gestation. The latest report by Nercolini et al [13] in this issue lends further support to this nonsurgical therapeutic approach.…”

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confidence: 62%

Percutaneous mitral valvuloplasty by the Inoue balloon technique is the ideal procedure for treatment of significant mitral stenosis in pregnant women

Cheng

2002

Cathet Cardio Intervent

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“…[ 12 ] Percutaneous mitral valvuloplasty should be considered if cardiac performance deteriorates. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

et al. 2015

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Background:Pulmonary hypertension (PH) in pregnancy is associated with a high maternal mortality and morbidity and has been found to be as high as 30-56%.Aim:To review the management of such patients in a tertiary center over a 15 year period, as the current literature consists of a few case reports, a few small case series and 2 meta-analyses.Materials and Methods:A review of all patients admitted to our institution for management of PH in pregnancy between 1994 and February 2009 was undertaken. Cases were identified from the high-risk pregnancy database within the department of anesthesia and from the hospital medical records. Severity of PH, type of PH, NYHA functional status at presentation and delivery, mode of delivery, peripartum monitoring and APGAR scores were noted. Patients were reviewed by a multidisciplinary team and management planned accordingly.Results:19 eligible patients were identified. Patients who were significantly sick due to their PH were aggressively managed during pregnancy. Overall there was an improvement in NYHA functional status at the time of delivery. Epidural analgesia and anesthesia for labor and operatively delivery seem to be the ideal choice.Conclusion:Multidisciplinary approach is a key to the successful management of these patients. Secondary PH results in higher morbidity and mortality, in particular, older the age higher the maternal morbidity and mortality.

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Percutaneous mitral balloon valvuloplasty in pregnant women with mitral stenosis

Cited by 29 publications

References 35 publications

Comparative study on maternal and fetal outcome in pregnant women with rheumatic heart disease and severe mitral stenosis undergoing percutaneous balloon mitral valvotomy before or during pregnancy

Comparative study on maternal and fetal outcome in pregnant women with rheumatic heart disease and severe mitral stenosis undergoing percutaneous balloon mitral valvotomy before or during pregnancy

Percutaneous mitral valvuloplasty by the Inoue balloon technique is the ideal procedure for treatment of significant mitral stenosis in pregnant women

Pulmonary hypertension and pregnancy: The experience of a tertiary institution over 15 years

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