title: [Balloon mitral valve commissurotomy in pregnancy].
abstract: METHODS
  A 31-year-old woman with known postrheumatic mitral valve stenosis developed for the first time left heart failure in the 19th week of her fifth pregnancy. After intensive drug treatment she was in stage 3 (New York Heart Association classification). Apart from that the patient was in a good general condition and obstetrical status was according to the estimated duration of pregnancy. Auscultation revealed an apical diastolic murmur and mitral opening snap.
  
  
  METHODS
  Echocardiography demonstrated a mitral valve opening area of 0.85 cm2 (pressure-half time method); the mean gradient was 19 mm Hg.
  
  
  METHODS
  Because of the severity of the findings a percutaneous transvenous balloon valvotomy (according to Inoue) was performed in the 27th week of pregnancy, after careful lead shielding of abdomen and pelvis. Radiological screening time was 10 min. The invasively measured transvalvar pressure gradient was reduced from 28 to 4 mm Hg, echocardiographically determined mitral opening area increased to 1.5 cm2. Delivery was induced in the 36th week of pregnancy because of third-degree renal pelvis congestion. A healthy child, weighing 2850 g was delivered vaginally.
  
  
  CONCLUSIONS
  High-grade symptomatic mitral stenosis can, if necessary, be treated with a low-risk to mother and child by percutaneous balloon valvotomy.
authors.affiliation: Medizinische Klinik IV, Abteilung für Kardiologie.
authors.forename: W
authors.initials: W
authors.lastname: Burger
authors.forename: C
authors.initials: C
authors.lastname: Teupe
authors.forename: W D
authors.initials: WD
authors.lastname: Bussmann
authors.forename: C
authors.initials: C
authors.lastname: Ruppert
authors.forename: M
authors.initials: M
authors.lastname: Kühnert
authors.forename: H
authors.initials: H
authors.lastname: Klepzig
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008943:Mitral Valve / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D011256:Pregnancy Outcome
vernacular_title: Ballon-Mitralkommissurotomie in der Schwangerschaft.