Balloon Mitral Valvotomy in Gestational Women with Symptomatic Mitral Stenosis

Background: Rheumatic valvular heart disease, commonly mitral stenosis, complicate 1% of pregnancies. Balloon mitral valvuloplasty (BMV) is an established treatment of rheumatic mitral stenosis. Aim of the study was to assess the safety and efficacy of Balloon mitral valvuloplasty in pregnant women with severe mitral stenosis.

Materials and Methods: 66 patients who failed to respond to medical therapy undergoing BMV during pregnancy were analysed in this retrospective study. Mitral valve area (MVA), transmitral Mean valve gradient (MVG), and mitral regurgitation (MR), Pulmonary artery pressure (PAP) were assessed before and 24 hours after the procedure by transthoracic echocardiography. Patients were followed up to one month post BMV and neonates were monitored for the adverse effect of radiation.

Results: Mitral valve area increased from 0.83 ± 0.13 cm2 to 1.38 ± 0.29 cm2 (P = 0.007). Mean gradient mitral valve gradient decreased from 15.5 ± 7.4 mmHg to 3.36 ± 2.36 mmHg (P = 0.001). Pulmonary artery pressure decreased from 65.24 ± 17.9 to 50.45 ± 15.33 (P = 0.012). No maternal death, intrauterine growth restriction was observed.

Conclusion: Balloon mitral valvuloplasty has favourable immediate good outcomes for mothers and newborns.