Percutaneous mitral balloon comissurotomy in Tunisian pregnant women: A monocentric cohort study
Presenter
Ouday Benabdeljelil, PhD, Cardiology departement Mongi Slim Hospital, La Marsa, Tunisia
Ouday Benabdeljelil, PhD, Farès Azaiez, RIM Hentati, Mohamed Amine Soula, RIM BEN Romdhane, Rami Tlili and Youssef BEN Ameur, Cardiology departement Mongi Slim Hospital, La Marsa, Tunisia
Keywords: Structural Heart Disease (SHD), TEER/TMVR/Mitral Valve and Women's Health
Background
In obstetric practice, heart disease is one of the leading causes of maternal morbidity and mortality. Chronic rheumatic valvular heart disease accounts for 90 to 95% of the cardiac lesions that occur in pregnant women and still a major cause of mitral stenosis in our country. We aimed to study the safety and efficiency of percutaneous mitral balloon commissurotomy (PMC) during pregnancy.
Methods
This was a retrospective cohort study including all consecutive pregnant women admitted to the cardiology department of Mongi Slim University hospital for mitral stenosis and treated by PMC from 2005 to 2017. We analyzed the clinical characteristics of the patients as well as the effectiveness and safety of PMC for the treatment of severe mitral stenosis in pregnant women.
Results
A total of 14 patients were included. Mean age was 32 ± 2.7 years. Ten patients were in New York Heart Association functional class II at the time of procedure and two patients presented with acute heart failure. Wilkins score was less than 8 in 76% of patients. The procedure was performed using the Inoue balloon catheter technique in all cases. Commissurotomy was successfully achieved in all cases. Echocardiographic mitral valve area increased from 0,88 ± 0,19 to 1,61 ± 0,23 cm². There were no maternal or fetal deaths or procedural complications. All patients delivered at term. Two newborns were hypotrophic.
Conclusions
During pregnancy, PMC is the treatment of choice for severe mitral stenosis in patients who are refractory to medical treatment.