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Closed mitral valvotomy during pregnancy. A 20-year experience
P Pavankumar1, P Venugopal, U Kaul
1Department of Cardiothoracic, All India Institute of Medical Sciences, New Delhi.
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1988
Summary
Closed mitral valvotomy is a safe and effective procedure for pregnant women with severe mitral stenosis, improving their heart function and leading to successful deliveries with minimal fetal risk.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Obstetrics
Background:
- Rheumatic mitral stenosis poses significant risks during pregnancy.
- Severe mitral stenosis often necessitates intervention to improve maternal and fetal outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of closed mitral valvotomy in pregnant women with rheumatic mitral stenosis.
- To assess the impact of the procedure on maternal functional status and pregnancy outcomes.
Main Methods:
- Closed mitral valvotomy was performed on 126 pregnant women with severe mitral stenosis (valve area < 1 cm2).
- Patients were assessed preoperatively, postoperatively, and at 5- and 10-year follow-ups.
- Pregnancy and fetal outcomes, including delivery and infant development, were meticulously monitored.
Main Results:
- No surgical mortality was observed.
- 84% of women improved to NYHA class I postoperatively, with sustained improvement at long-term follow-up (86% in class I/II at 5 years).
- 82% of pregnancies resulted in full-term normal delivery with 6% fetal mortality; infants showed normal development.
Conclusions:
- Closed mitral valvotomy is a safe and reliable intervention for pregnant women with severe mitral stenosis.
- The procedure offers significant functional improvement for mothers without adverse fetal effects.
- Long-term follow-up demonstrates sustained benefits and acceptable rates of restenosis and late mortality.