[Results of percutaneous mitral balloon commissurotomy in pregnant women about 12 cases].
BACKGROUND
Mitral stenosis (MS) is the most common valvular heart disease revealed or exacerbated by pregnancy. Percutaneous mitral balloon commissurotomy (PMC) is currently the treatment of choice when mitral valve morphology is favorable.


OBJECTIVE
The purpose of this study is to evaluate the immediate, medium and long term results of percutaneous mitral balloon commissurotomy in pregnant women with a severe symptomatic mitral stenosis despite medical treatment.


METHODS
It is a retrospective study including 12 pregnant patients diagnosed with severe mitral stenosis and hospitalized in the cardiology department of Habib Thameur hospital between 1994 and 2014. A clinical and ultrasonographic monitoring was performed for over 15 years.


RESULTS
Mean patients age was 31.5±4.4 years. All patients were in NYHA class III or IV despite medical treatment. Mitral regurgitation was rated as moderate in four cases. Functional improvement was observed in all cases immediately after the procedure. Mitral valve area increased from 1.02±0.5cm2averaged to 2±0.35cm2. Mitral regurgitation increased in three cases and appeared in two cases. All patients delivered at term. Newborns were all healthy. Two of them had a low birth weight. On the long term follow-up (95.58±64.1 months), five patients had mitral restenosis: two had a surgical valve replacement and three underwent a second percutaneous mitral balloon commissurotomy.


CONCLUSIONS
The effectiveness of the percutaneous mitral balloon commissurotomy is clearly documented by clinical and echocardiographic evaluation. In the case of pregnancy, the goal is not so much to obtain an optimal result but to cause hemodynamic improvement authorizing the continuation of pregnancy and childbirth.
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie. Electronic address: zairiihsen@yahoo.fr.
I
I
Zairi
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
K
K
Mzoughi
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
F
F
Mroua
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
F
F
Ben Moussa
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
I
I
Amri
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
S
S
Kammoun
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
S
S
Fennira
Service de cardiologie, hôpital Habib Thameur, 3, rue A.-Ben-Ayed, 1089 Tunis Chebbi, Tunis, Tunisie.
S
S
Kraiem
D000328:Adult; D063126:Balloon Valvuloplasty / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008946:Mitral Valve Stenosis / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
Ballon d’Inoué; Commissurotomie mitrale percutanée; Grossesse; Inoue balloon; Mitral stenosis; Percutaneous mitral balloon commissurotomy; Pregnancy; Restenosis; Resténose; Rétrécissement mitral