Percutaneous balloon mitral valvuloplasty during pregnancy. Report of two cases in a level IV hospital in Cali, Colombia, and review of the literature
DOI:
https://doi.org/10.18597/rcog.1096Keywords:
Mitral valve stenosis, balloon valvuloplasty, pregnancyAbstract
Objective: To describe the experience of two cases of pregnant women with mitral stenosis taken to percutaneous balloon valvuloplasty and dilatation as a therapeutic option to counteract the risk of collapse and maternal and foetal
deterioration, and to allow progression of the gestation without cardiovascular complications or functional impairment; and to conduct a review of the published literature regarding this procedure in pregnant women.
Materials and methods: Two cases of severe mitral stenosis and associated functional involvement of early onset during the second trimester of pregnancy, seen in a level IV regional referral centre. The two cases were managed with balloon mitral valvuloplasty, with favourable perinatal maternal outcomes. The review of the literature was done using the terms Valvulopasty, Mitral Stenosis and Pregnancy. A search was conducted in Medline via Pubmed and in the MEDES and
SCOPUS databases. Procedures described for the performance of foetal valve repair were excluded. Studies were focused on the diagnostic findings and the course of the surgical procedure.
Results: Overall, 12 titles were identified. The results obtained are comparable with the case reports found in the literature on mitral valve stenosis using balloon-assisted procedures for valve dilatation. In general terms, the procedure is successful, increasing the area of the mitral valve and reducing the pressure gradient across the valve. However, there is a risk of mitral regurgitation, thrombosis and death following the procedure.
Conclusion: Percutaneous mitral valvuloplasty with balloon dilatation is a therapeutic option that may be considered for the management of mitral stenosis in pregnant women with functional class deterioration and increasing pulmonary wedge pressure during follow-up. Controlled studies are required in order to validate the results of observational studies.
Author Biographies
Alejandro Colonia-Toro
María Fernanda Escobar-Vidarte
Jorge Velásquez-Noreña
Sara Sofía Escobar-González
Angélica María Forero-Ladino
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