| Summary: | The study aim was to examine the long-term outcome (nine years) of mitral balloon valvotomy in pregnant patients with severe mitral stenosis.
Methods: Twenty-three patients with severe, symptomatic (NYHA class III/IV) mitral stenosis underwent material balloon valvotomy using an lnoue balloon technique during the second trimester of their pregnancy; mean follow up was 5.1 ± 2.8 year (range: 1–9 years).
Results: The procedure was successful in all patients. Immediately after valvotomy, the Doppler-derived mitral valve area increased from 0.90 ± 0.18 to 1.97 ± 0.36 cm2 (p < 0.0001), and the transmitral mean gradient decreased from ‘15.7 ± 4.7 to 5.5 ± 1.6 mmHg (p < 0.0001). Four patients had mild worsening of mitral regurgitation, and six developed insignificant interatrial communication immediately after valvotomy. There was no other morbidity or mortality. Patients showed a significant improvement in mean NYHA class Twenty-two patients had normal deliveries; one cesarean section in week 36 resulted in stillbirth. No developmental abnormalities were seen in the babies. At long-term follow up of mothers, the mitral valve area was 1.8 ± 0.52 cm2, restenosis developed in three patient (16%). One baby died at one week from sudden infant death syndrome, one at eight months from pneumonia. All other children showed normal growth, development and speech for their age.
Conclusion: Mitral balloon valvotomy using the Inoue balloon technique can provide satisfactory immediate and long-term outcome in pregnant patients with severe mitral stenosis.
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