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Immediate maternal and fetal outcome following percutaneous mitral valve balloon commissurotomy: a 6-year single-center experience from sub-Saharan Africa

Part of: Interventional Cardiology

Published online by Cambridge University Press:  07 February 2022

Mohammed Bedru Sebah ,
Azene Dessie Mengistu ,
Kefelegn Dejene Tadesse  and
Atnafu Mekonnen Tekleab Open the ORCID record for Atnafu Mekonnen Tekleab [Opens in a new window]
Mohammed Bedru Sebah
Affiliation:
Cardiac Center of Ethiopia, Addis Ababa, Ethiopia
Azene Dessie Mengistu
Affiliation:
Cardiac Center of Ethiopia, Addis Ababa, Ethiopia
Kefelegn Dejene Tadesse
Affiliation:
Cardiac Center of Ethiopia, Addis Ababa, Ethiopia
Atnafu Mekonnen Tekleab*
Affiliation:
Department of Pediatrics and Child Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
*
Author for correspondence: A. M. Tekleab, MD, MPH, Department of Pediatrics and Child Health, St Paul’s Hospital Millennium Medical College, P.O Box-1271, Addis Ababa, Ethiopia. Tel: +251911346601; Fax: +251112788592. Email: atnemekonnen@yahoo.com
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Abstract

Background:

Mitral stenosis is the most common valvular heart disease during pregnancy. When severe, it leads to significant maternal and fetal morbidity and mortality. Percutaneous mitral valve balloon commissurotomy can be performed during pregnancy, and the present study aimed to describe the immediate maternal and fetal outcomes after percutaneous mitral valve balloon commissurotomy was done in a cohort of 23 pregnant patients with severe mitral stenosis in Addis Ababa, Ethiopia.

Methods:

Included in the current study were all pregnant mothers who had severe rheumatic mitral valve stenosis and who underwent percutaneous mitral valve balloon commissurotomy at the Cardiac Center of Ethiopia over 6-year period. Data were collected through chart abstraction using a structured proforma and then analysed using STATA version 13.0.

Result:

Median gestational age was 22 weeks and percutaneous mitral valve balloon commissurotomy was successful resulting in a significant increase in the mean mitral valve area of the group from 0.78 ± 0.20 cm2 to 1.89 ± 0.31 cm2 (p < 0.001). The mean mitral valve inflow gradient of the group was 23.95 ± 6.27 mmHg and 6.80 ± 2.44 mmHg, respectively, before and after the percutaneous mitral valve balloon commissurotomy procedure (p < 0.001). Post-procedure, there was no significant increment in mitral valve incompetence. The mean pulmonary artery pressure of the group decreased from 77.68 ± 23.19 mmHg to 42.31 ± 9.95 mmHg (p < 0.001). There was no fetal or maternal death following the procedure. Pregnancy ended at term gestation for 19/23 (82.6%) of the mothers and the mean birth weight of the neonates was 2800 g.

Conclusion:

Percutaneous mitral valve balloon commissurotomy procedure can safely be done for severe symptomatic rheumatic mitral stenosis in pregnancy in our setting.

Keywords

Rheumatic heart diseasepercutaneous commissurotomypregnancymitral stenosis
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1616 - 1620
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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