The role of mitral valve balloon valvuloplasty in the treatment of rheumatic mitral valve stenosis during pregnancy

Objective. To analyze the immediate results and the clinical evolution of a group of fertile age women with rheumatic mitral stenosis, in whom percuta neous ballon mitral valvuloplasty was performed before or during pregnancy. Patients and method. Eighty-one women with mitral stenosis, submitted to b allon mitral vavuloplasty, were studied. They were divided into three group s, according to their desire of no further pregnancies (group A; n = 19), p regnancy during the follow-up (group B; n = 23) or valvuloplasty was perfor med during pregnancy (group C; n 39). Patients from group B and C were cont rolled during pregnancy, childbirth and puerperium, and the newborns of wom en in group C were followed from birth to the age of 5 years. Results. Mort ality-in the three groups was null and the incidence of miscarriage was 2 ( 8.6%) in group B and 3 (9.1%) in group C. Normal delivery was predominant i n group B and delivery by caesarean was predominant in group B. Success was immediate in all the cases. The procedure was repeated in 3 women due to r estenosis. The media valvar area rase from 0.93 to 2.05 cm(2) in group A, f rom 1.28 to 2.04 cm(2) in group B and from 0.84 to 2.14 cm(2) in group C (i ntergroup p = NS). The functional class improved in the three groups of pat ients. Conclusion. Percutaneous ballon mitral valvuloplasty is an effective , efficient method for the treatment of rheumatic mitral stenosis during pr egnancy, after organogenesis, or at any time in a woman's life, as long as it is indicated according to clinical and echocardiographic evaluation crit eria.