Document Detail


Transventricular mitral commissurotomy in critical mitral stenosis during pregnancy.
MedLine Citation:
PMID:  15353462     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of a pregnant patient with mitral stenosis is a subject of debate with regards to the optimal type of treatment and the time of intervention. We performed trans-ventricular mitral commissurotomy (TVMC) either as an isolated procedure in the second trimester, or in combination with Cesarian section at term. We retrospectively analyzed our experience with TVMC during pregnancy and formulated a protocol for its management. Between January 1987 and April 2002, fifty one patients underwent TVMC for critical mitral stenosis during pregnancy. In 38 patients, elective TVMC was performed during the second trimester, while in 12, it was performed as an initial procedure along with Cesarian section at term. One patient had an emergency TVMC in the second trimester when she presented with intractable acute pulmonary edema. There were no maternal mortalities. Three patients who developed post-operative mitral regurgitation were managed conservatively. Another two patients who developed cerebral embolism with hemiplegia recovered completely without any neurological deficit. There was only one fetal death in a patient where TVMC was performed as an emergency procedure for acute pulmonary edema. We conclude that TVMC in pregnancy is a safe, cost effective alternative in critical mitral stenosis complicating pregnancy.
Authors:
Kasturi S V K Subbarao; Muthuraman Nachiappan; Antao P Irineu
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  12     ISSN:  0218-4923     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-08     Completed Date:  2005-01-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  233-5     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India. subbarao_ksvk@rediffmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Fibrillation / etiology
Balloon Dilatation / methods
Cardiac Surgical Procedures / methods*
Cesarean Section
Female
Humans
Mitral Valve / pathology,  surgery
Mitral Valve Insufficiency / etiology
Mitral Valve Stenosis / complications,  surgery*
Postoperative Care
Postoperative Complications
Pregnancy
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Retrospective Studies
Time Factors
Toxoplasmosis, Cerebral / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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