EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2006
Long term outcome of balloon mitral commissurotomy during pregnancy: a prospective physical and mental evaluation of babies.
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Gamra H, Ben-Farhat M, Betbout F, Addad F, Ben-Rejeb R, Dridi Z, Khedher S, Ben-Hamda K, Maatouk F, Maaoui S
Аннотация
AIM: The immediate and long-term results of balloon mitral commissurotomy (BMC) during pregnancy were evaluated in patients and in their babies looking for radiation side effects.
METHODS AND RESULTS: Sixty one patients (mean age: 28.5+/-5.0 years) had BMC at a mean age of gestation of 26.8+/-5.5 weeks. The procedure was successful in all patients except in one who had a severe mitral regurgitation and subsequent mitral valve replacement (MVR). All patients delivered at term vaginally in 58 (95.1%) cases. There was only one death in a patient who delivered at home. At a mean follow-up of 66.8+/-36.0 months, 4 patients had MVR, the remaining were in NYHA class I/II. Restenosis was found in 4 (7.2%) patients. The 63 babies (two gemellar pregnancies) had a normal weight of birth except of one case of hypotrophy. At a mean follow-up of 64.5+/-32.5 months, two babies died, 1 had hypotrophy, 2 had microcephaly, 8 had an IQ < 70 but none had a severe mental retardation (IQ <34). None of these events were radiation related.
CONCLUSION: BMC is the procedure of choice in pregnant patients with mitral stenosis. No late radiation side effects were observed in children but longer follow-up is required.
METHODS AND RESULTS: Sixty one patients (mean age: 28.5+/-5.0 years) had BMC at a mean age of gestation of 26.8+/-5.5 weeks. The procedure was successful in all patients except in one who had a severe mitral regurgitation and subsequent mitral valve replacement (MVR). All patients delivered at term vaginally in 58 (95.1%) cases. There was only one death in a patient who delivered at home. At a mean follow-up of 66.8+/-36.0 months, 4 patients had MVR, the remaining were in NYHA class I/II. Restenosis was found in 4 (7.2%) patients. The 63 babies (two gemellar pregnancies) had a normal weight of birth except of one case of hypotrophy. At a mean follow-up of 64.5+/-32.5 months, two babies died, 1 had hypotrophy, 2 had microcephaly, 8 had an IQ < 70 but none had a severe mental retardation (IQ <34). None of these events were radiation related.
CONCLUSION: BMC is the procedure of choice in pregnant patients with mitral stenosis. No late radiation side effects were observed in children but longer follow-up is required.