Assessment of the Outcome of Severe Mitral Stenosis during Late Pregnancy

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摘要 ObjectivesPercutaneousballoonmitralvalvuloplasty(PBMV)isonewaytoimprovetherheumaticmitralstenosis.Howdoestheprocedureworkingravidaandfetusisnotveryclear.WeanalyzedtheeffectsandsafetyofPBMVoperationonpregnantpatientswithsevererheumaticmitralstenosis.MethodsEightpregnantpatientssufferingfromseveremitralstenosisunderwentfacilitatedPBMVoperationwithInoueballoon,andwerefollowedupfor(2.0±1.1)years.Contentsincludedoutcomeofpregnancy,infantgrowth,hemodynamics,echocardiography,cardiacfunction,mitralvalvesreplacementorrepeatvalvuloplasty.ResultsMitralvalvearea(MVA)before,oneweekandoneyearafterfacilitatedPBMVwere(0.84±0.21)cm2,(1.69±0.23)cm2and(1.51±0.24)cm2respectively.Thetransmitralpressuregradientdroppedfrom(22.1±4.7)mmHgto(9.9±3.1)mmHg(P<0.001)(1mmHg=0.133kPa).AfterfacilitatedPBMV,allpatientsshowedremarkableimmediatesymptomaticandhemodynamicimprovementwithoutseveremitralregurgitation.AllofthesepatientscouldmaintainNewYorkheartassociation(NYHA)ⅠorⅡfor(2.0±1.1)yearsaftertheoperation.TwopatientsdemandedinducedabortionconcerningabouttheteratogeniceffectofX-rayonfetus.Alltheothersixpatientscontinuedtheirgestationandhadfull-termcesareansectionwithoutcomplications.Theirnewbornsdevelopedhealthyandnormallytillnow.ConclusionsFacilitatedPBMVisafeasible,safeandeffectivedeviceforselectedpregnantpatientswithmitralstenosis.Theoperationiswelltoleratedbythefetus.
机构地区 不详
出版日期 2008年04月14日(中国期刊网平台首次上网日期,不代表论文的发表时间)
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