ISSN 2149-2263 | E-ISSN 2149-2271
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Maternal and Fetal Outcomes Following Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Critical Mitral Stenosis: An Experience of a Tertiary Care Center from Northern India [Anatol J Cardiol]
Anatol J Cardiol. 2022; 26(7): 552-558 | DOI: 10.5152/AnatolJCardiol.2022.1644

Maternal and Fetal Outcomes Following Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Critical Mitral Stenosis: An Experience of a Tertiary Care Center from Northern India

Rajesh Vijayvergiya1, Vanita Suri2, Pooja Sikka2, Ganesh Kasinadhuni1, Ankush Gupta1, Navjyot Kaur1, Sujata Siwatch2, Neelam Aggarwal2, Seema Chopra2
1Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
2Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education & Research, Chandigarh, India

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.

Keywords: Balloon mitral valvuloplasty, mitral stenosis, Percutaneous transvenous mitral commissurotomy, pregnancy, valvular heart disease

Rajesh Vijayvergiya, Vanita Suri, Pooja Sikka, Ganesh Kasinadhuni, Ankush Gupta, Navjyot Kaur, Sujata Siwatch, Neelam Aggarwal, Seema Chopra. Maternal and Fetal Outcomes Following Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Critical Mitral Stenosis: An Experience of a Tertiary Care Center from Northern India. Anatol J Cardiol. 2022; 26(7): 552-558

Corresponding Author: Rajesh Vijayvergiya
Manuscript Language: English


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