Percutaneous transvenous balloon mitral valvoplasty for severe mitral stenosis in a 31-year-old pregnant woman

History and clinical findings: A 31-year-old woman presented in the 25th we ek of pregnancy with ankle and pretibial oedema and increasing dyspnoea, ul timately in class IV (New York Heart Association classification). There wer e fine rales on auscultation and dullness on palpation over both lung bases . The heart rate was regular at 110/min. The first heart sound was very lou d, and there was a mitral opening snap and a loud diastolic murmur maximal, over the cardiac apex. Investigations: The ECG showed sinus rhythm at a rate of 110/min, left axis deviation, incomplete right bundle branch block and P biatriale, but no ot her abnormalities. Echocardiography revealed biatrial enlargement and an en larged right ventricle as well as pulmonary systolic hypertension of 100 mm Hg. Doppler sonography demonstrated severe mitral stenosis with a calculat ed mitral opening area of 0.9 cm(2). Diagnosis, treatment and course: The symptoms improved only slightly under conservative drug treatment. The mitral valve changes, as noted sonographic ally, met the criteria for percutaneous transluminal balloon mitral valvopl asty (PTBMV), which was successfully performed. Afterwards the mitral openi ng area was 2.6 cm(2) and pulmonary artery pressure gradually became normal . She was delivered without complication of a healthy child in the 39th wee k of pregnancy. Conclusion: PTBLMV is a relatively low-risk treatment in pregnant women wit h symptomatic mitral stenosis.