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ISSN 0188-2198 (Print)

2004, Number 3

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Rev Mex Cardiol 2004; 15 (3)

Interventionism treatment in patients with unstable angina postinfarction: TIMI influence. Experience of an Hospital Centre, follow up to long term

Palacios RJM, Comparan N A, Torres HM, Bazzoni RA, Ibarra FM

Language: Spanish
References: 26
Page: 113-117
PDF size: 74.68 Kb.


ABSTRACT

From October 1990, to December 2003, a total of 950 patients with mitral stenosis were treated by Percutaneous balloon mitral commissurotomy (PBMC) at our Hospital. The purpose of this work is to inform of 8 pregnant patients (mean age 32 + 7.89 years) with rheumatic mitral stenosis treated by this technique. Functional class (NYHA) was III in 6, and IV in 2 patients. In 6 patients Wilkins echo score was 8 and in the remaining 2 was 9 and 10 points respectively. Duration of pregnancy was 31.14 + 5.01 weeks (range 24-38). PBMC was accomplished successfully in all 8 patients. Mitral valve area by planimetry increased from 0.79 + 0.14 to 1.90 + 0.21 cm2; transvalvular mitral gradient decreased from 21.25 + 5.87 to 2.8 + 1.06, left atrial pressure desplased from 31 + 7.42 to 11 + 6.32 and pulmonary artery pressure from 57 + 20.8 to 33.14 + 16.1 mmHg (all p 0.001). In order to limit fetal exposure to radiation, all evaluations prior and during the procedure were done by transthoracic-echocardiography (TTE), avoiding contrast angiography. All patients were discharged from the hospital clinically improved 24 to 48 hours after PBMC. Delivery ocurred at 37.0 + 1.67 weeks by vaginal route without complications or adverse effects related to the technique noted. Mean follow up of 15.14 + 11.65 months revealed all patients in funcional class I, with mitral valve area of 1.8 + 0.09 cm2. Conclusion: PBMC can be accomplished safely and with excellent results in pregnant patients with mitral stenosis eligible for mitral commissurotomy; this procedure should be considered the treatment of choice during pregnancy.


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