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Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis

Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aim...

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Autores principales: Firouzi, Ata, Samiei, Niloufar, Ahmadi, Somayyeh, Naderi, Nasim, Sadeghipour, Parham, Sanati, Hamid Reza, Kashfi, Fahimeh, Sattarzadeh, Roya, Hantoushzadeh, Sedigheh, Bayat, Maryam, Pourtaghi, Sanaz, Nasiri, Mohsen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences, 2006- 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560256/
https://www.ncbi.nlm.nih.gov/pubmed/31210765
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author Firouzi, Ata
Samiei, Niloufar
Ahmadi, Somayyeh
Naderi, Nasim
Sadeghipour, Parham
Sanati, Hamid Reza
Kashfi, Fahimeh
Sattarzadeh, Roya
Hantoushzadeh, Sedigheh
Bayat, Maryam
Pourtaghi, Sanaz
Nasiri, Mohsen
author_facet Firouzi, Ata
Samiei, Niloufar
Ahmadi, Somayyeh
Naderi, Nasim
Sadeghipour, Parham
Sanati, Hamid Reza
Kashfi, Fahimeh
Sattarzadeh, Roya
Hantoushzadeh, Sedigheh
Bayat, Maryam
Pourtaghi, Sanaz
Nasiri, Mohsen
author_sort Firouzi, Ata
collection PubMed
description Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes of pregnant women with mitral stenosis who underwent PTMC. Methods: Thirty-one patients undergoing PTMC during pregnancy were enrolled in this study. The mitral valve area (MVA), the transmitral valve mean gradient (MVMG), and the severity of mitral regurgitation were assessed pre- and postprocedurally by transthoracic and transesophageal echocardiography. The radiation time was measured during the procedure. The patients were followed up during pregnancy, and the neonates were monitored for weight, height, the head circumference, the birth Apgar score, and the adverse effects of radiation for at least 12 months. Results: PTMC was successfully performed on 29 (93.5%) patients. No maternal death or pulmonary edema was reported. The mean MVA significantly increased (from 0.73±0.17 cm(2) to 1.28±0.24 cm(2); P<0.001), and the mean MVMG significantly decreased (from 19.62±5.91 mmHg to 8.90±4.73 mmHg; P<0.001) after the procedure. A significant decrease in the systolic pulmonary artery pressure was also detected. Mitral regurgitation did not increase in severity in 16 (51.6%) patients. There was no significant relationship between the Apgar score, weight, height, and the head circumference at birth and at the radiation time. Conclusion: In our series, PTMC during pregnancy was a safe and effective procedure. Lowering the radiation time with low frame-count techniques confers a significant decrease in radiation-related complications.
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spelling pubmed-65602562019-06-17 Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis Firouzi, Ata Samiei, Niloufar Ahmadi, Somayyeh Naderi, Nasim Sadeghipour, Parham Sanati, Hamid Reza Kashfi, Fahimeh Sattarzadeh, Roya Hantoushzadeh, Sedigheh Bayat, Maryam Pourtaghi, Sanaz Nasiri, Mohsen J Tehran Heart Cent Original Article Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes of pregnant women with mitral stenosis who underwent PTMC. Methods: Thirty-one patients undergoing PTMC during pregnancy were enrolled in this study. The mitral valve area (MVA), the transmitral valve mean gradient (MVMG), and the severity of mitral regurgitation were assessed pre- and postprocedurally by transthoracic and transesophageal echocardiography. The radiation time was measured during the procedure. The patients were followed up during pregnancy, and the neonates were monitored for weight, height, the head circumference, the birth Apgar score, and the adverse effects of radiation for at least 12 months. Results: PTMC was successfully performed on 29 (93.5%) patients. No maternal death or pulmonary edema was reported. The mean MVA significantly increased (from 0.73±0.17 cm(2) to 1.28±0.24 cm(2); P<0.001), and the mean MVMG significantly decreased (from 19.62±5.91 mmHg to 8.90±4.73 mmHg; P<0.001) after the procedure. A significant decrease in the systolic pulmonary artery pressure was also detected. Mitral regurgitation did not increase in severity in 16 (51.6%) patients. There was no significant relationship between the Apgar score, weight, height, and the head circumference at birth and at the radiation time. Conclusion: In our series, PTMC during pregnancy was a safe and effective procedure. Lowering the radiation time with low frame-count techniques confers a significant decrease in radiation-related complications. Tehran University of Medical Sciences, 2006- 2019-01 /pmc/articles/PMC6560256/ /pubmed/31210765 Text en Copyright © 2015 Tehran Heart Center, Tehran University of Medical Sciences This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Firouzi, Ata
Samiei, Niloufar
Ahmadi, Somayyeh
Naderi, Nasim
Sadeghipour, Parham
Sanati, Hamid Reza
Kashfi, Fahimeh
Sattarzadeh, Roya
Hantoushzadeh, Sedigheh
Bayat, Maryam
Pourtaghi, Sanaz
Nasiri, Mohsen
Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis
title Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis
title_full Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis
title_fullStr Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis
title_full_unstemmed Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis
title_short Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis
title_sort percutaneous transluminal mitral commissurotomy in pregnant women with severe mitral stenosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560256/
https://www.ncbi.nlm.nih.gov/pubmed/31210765
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