Perinatal mitral valve interventions: A report of 10 cases

Background. Rheumatic mitral valve stenosis is still an endemic disease in some parts of the world and may complicate pregnancy and perinatal period. During the 10-year period between January 1988 and December 1997, 10 pregna nt women with mitral stenosis were operated on. Methods. Combined cesarean delivery and closed mitral valvulotomy (CMV) wer e performed on 6 patients, combined cesarean delivery and Mitral Valve Repl acement (MVR) were performed on 1 patient, and 3 patients had CMV during th eir third trimester. Results. There was 1 stillbirth. All other patients and delivered babies we re healthy. MVR was necessary for mitral restenosis in one patient 5 years after her CMV. Three of the remaining patients had some degree of restenosi s but did not require reoperation. Conclusion. CMV when indicated during pregnancy can be performed with low r isk. For symptomatic patients responding to medical therapy, a combined app roach of cesarean section and CMV will prevent possible complications that may arise on perinatal period due to hemodynamic fluctuation. (Ann Thorac S urg 1999;67:1312-4) (C) 1999 by The Society of Thoracic Surgeons.