Adnan Mehmood Gul, Shah Zeb, Umar Hayat, Mohammad Irfan, Mohammad Hafizullah.
Outcomes of percutaneous transluminal mitral commissurotomy (PTMC) for severe mitral stenosis in pregnancy.
Pak Heart J Jan ;48(4):172-6.

Objective: To know short term outcomes of PTMC for severe isolated mitral stenosis in pregnancy. Methodology: This observational study was performed in Cardiology Unit of Lady Reading Hospital Peshawar from January 2003 to December 2014. All patients with symptomatic severe isolated mitral stenosis with no more than moderate degree mitral regurgitation were included in the study. They were followed till delivery. Results: A total number of 36 pregnant patients undergoing PTMC for isolated severe mitral stenosis were included in the study. Mean age was 29+-6.3 years.Mild mitral regurgitation was found in 18(50%) of patients, moderate mitral regurgitation in 3(8.3%) while there was no mitral regurgitation in 15(41.7%)patients. Mean mitral valve area was 0.8+-0.36 cm . Mean mitral valve gradient was 23+-11 mm of Hg. There mean left atrium size was 4.7+-1.2cm. Mean ejection fraction was 58.43%. Mean pulmonary artery pressure was 45.8+-16.4 mm of Hg. PTMC was performed in second trimester in 32(88.88%) patients and in third trimester in 4(11.11%) patients. PTMC was successful in 33(91.6%).Post PTMC mitral valve area was 1.8+-0.82 cm . The mean mitral valve gradient was 4+-3.2 mm of Hg. Mean left atrium size was 4.61+- 2.34 cm. Mild mitral regurgitation was found in 17(47.22%). Moderate mitral regurgitation was found in 5(13.8%) of patients. Acute severe mitral regurgitation occurred in 1(2.7%)patient, for which emergency mitral valve replacement was arranged but expired.One (2.7%) had still birth. The mean fluoroscopy time was 9.3+-7.2 minutes. Conclusion: PTMC is safe and effective procedure for severe symptomatic mitral stenosis in pregnant patients.

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