title: Immediate results of percutaneous trans-luminal mitral commissurotomy in pregnant women with severe mitral stenosis.
abstract: BACKGROUND
  Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms. PTMC is an established non-surgical treatment of rheumatic mitral stenosis. The study aimed to assess the safety and efficacy of PTMC in pregnant women with severs mitral stenosis.
  
  
  METHODS
  Thirty three consecutive patients undergoing PTMC during pregnancy enrolled in this prospective study. Mitral valve area (MVA), transmitral valve gradient (MVG), and severity of mitral regurgitation (MR) were assessed before and 24 hour after the procedure by transthoracic and transesophageal echocardiography. Mitral valve morphology was evaluated before the procedure using Wilkin's criteria. Patient followed for one month and neonates monitored for weight and height and adverse effect of radiation.
  
  
  RESULTS
  Mitral valve area increased from 0.83 ± 0.13 cm(2) to 1.38 ± 0.29 cm(2) (P = 0.007). Mean gradient of mitral valve decreased from 15.5 ± 7.4 mmHg to 2.3 ± 2.3 mmHg (P = <0.001). Pulmonary artery pressure decreased from 65.24 ± 17.9 to 50.45 ± 15.33 (P = 0.012). No maternal death, abortion, intrauterine growth restriction was observed and only one stillbirth occurred.
  
  
  CONCLUSIONS
  PTMC in pregnant women has favorable outcome and no harmful effect on children noted.
authors.affiliation: Associated Professor, Department of Interventional Cardiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Science.
authors.forename: Seyfollah
authors.initials: S
authors.lastname: Abdi
authors.forename: Negar
authors.initials: N
authors.lastname: Salehi
authors.forename: Babak
authors.initials: B
authors.lastname: Ghodsi
authors.forename: Hossein Ali
authors.initials: HA
authors.lastname: Basiri
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Momtahen
authors.forename: Ata
authors.initials: A
authors.lastname: Firouzi
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Sanati
authors.forename: Farshad
authors.initials: F
authors.lastname: Shakerian
authors.forename: Mohsen
authors.initials: M
authors.lastname: Maadani
authors.forename: Homan
authors.initials: H
authors.lastname: Bakhshandeh
authors.forename: Soheila
authors.initials: S
authors.lastname: Chamanian
authors.forename: Mitra
authors.initials: M
authors.lastname: Chitsazan
authors.forename: Anoushiravan
authors.initials: A
authors.lastname: Vakili-Zarch