1/41. Perinatal mitral valve interventions: a report of 10 cases.BACKGROUND: Rheumatic mitral valve stenosis is still an endemic disease in some parts of the world and may complicate pregnancy and perinatal period. During the 10-year period between January 1988 and December 1997, 10 pregnant women with mitral stenosis were operated on. methods: Combined cesarean delivery and closed mitral valvulotomy (CMV) were performed on 6 patients, combined cesarean delivery and Mitral Valve Replacement (MVR) were performed on 1 patient, and 3 patients had CMV during their third trimester. RESULTS: There was 1 stillbirth. All other patients and delivered babies were healthy. MVR was necessary for mitral restenosis in one patient 5 years after her CMV. Three of the remaining patients had some degree of restenosis but did not require reoperation. CONCLUSION: CMV when indicated during pregnancy can be performed with low risk. For symptomatic patients responding to medical therapy, a combined approach of cesarean section and CMV will prevent possible complications that may arise on perinatal period due to hemodynamic fluctuation.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/41. Cardiac operations during pregnancy: review of factors influencing fetal outcome.Women with underlying rheumatic heart disease, even if well compensated, can easily be affected by acute heart failure caused by out-of-the-ordinary cardiorespiratory requirements during pregnancy. In such cases, medical therapy is not always sufficient to drive a heart, and open heart operation might be necessary. Many factors associated with cardiac operations requiring cardiopulmonary bypass, such as hypothermia, can adversely affect both the mother and the fetus, but the morbidity and mortality rates are higher for the fetus than the mother. Because fetal heart tones were lost during cardiopulmonary bypass and were reheard in the intensive care unit in our case presentation, we have presumed that the loss of fetal heart tones should not always indicate fetal death and have discussed harmful factors in relation with the fetal morbidity and mortality in light of the literature.- - - - - - - - - - ranking = 2.5keywords = pregnancy (Clic here for more details about this article) |
3/41. Mitral valve plasty in systemic lupus erythematosus in the setting of antiphospholipid syndrome.The first case was of a 27-year-old female, who was diagnosed as having mitral valve stenosis with regurgitation, systemic lupus erythematosus and antiphospholipid syndrome at her previous pregnancy. We performed mitral valve plasty, which included open mitral commissurotomy and Kay's annulo plasty. The second case was of a 53-year-old female, who was diagnosed as old myocardial infarction, mitral regurgitation, systemic lupus erythematosus and antiphospholipid syndrome. She underwent mitral valve plasty and coronary artery bypass grafting. Both cases were treated by administration of methylpredonisolone and heparin perioperatively to avoid thrombosis and aggravation of systemic lupus erythematosus. Both patients showed good postoperative outcome without complications. We consider that it is important to perform the plasty as far as possible, and to administer effective anticoagulation treatment to prevent complications for patients in the setting of systemic lupus erythematosus and antiphospholipid syndrome.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
4/41. Mitral balloon valvuloplasty during pregnancy in developing countries.Two women presented with severe mitral stenosis at 28th and 23rd weeks of gestation, respectively. Both did not respond to medical therapy and percutaneous balloon valvuloplasty was performed during pregnancy successfully. While one of the women gave no history of cardiac disease the other had already underwent balloon valvuloplasty twice due to restenosis of the mitral valve. The rest of their pregnancies were both uncomplicated. They discontinued their medication. Both were able to deliver vaginally at term. Percutaneous balloon valvuloplasty is a promising approach to the treatment of patients with rheumatic mitral stenosis if medical management is unsuccessful.- - - - - - - - - - ranking = 2.8506921630438keywords = pregnancy, gestation (Clic here for more details about this article) |
5/41. Percutaneous balloon mitral valvuloplasty during a twin gestation.Although percutaneous balloon mitral valvuloplasty is known to be a safe and effective procedure during a singleton pregnancy, its use during a twin gestation is limited to a single report with a poor obstetric outcome. In the case we are reporting, a 29-year-old nulliparous patient with a twin gestation was seen at 24 weeks' gestation with congestive heart failure caused by previously undiagnosed mitral stenosis. She had successful percutaneous balloon mitral valvuloplasty, and two healthy infants were subsequently delivered at 36 weeks' gestation.- - - - - - - - - - ranking = 3.3055373043502keywords = pregnancy, gestation (Clic here for more details about this article) |
6/41. Open heart surgery during pregnancy--case report.A case of a 32-year-old woman in her 7th month of pregnancy presented with intractable pulmonary edema due to mitral restenosis is reported. Open-heart mitral commissurotomy was done as an emergency procedure. She continued pregnancy to term after the operation and delivered a healthy female baby. The literature related to "the closed" and "open" heart surgery during pregnancy has been reviewed.- - - - - - - - - - ranking = 3.5keywords = pregnancy (Clic here for more details about this article) |
7/41. Heart valve replacement; anticoagulation and pregnancy.Three patients who had heart valve replacement surgery and were on anticoagulation therapy with warfarin presented with pregnancy, one patient in the first trimester and the other two patients in the second trimester All three patients were in good and stable haemodynamic condition and went through pregnancy without any Complications. Delivery in all three patients were by caesarian section. The management of these patient during pregnancy and delivery form the basis of this report. A scheme for anticoagulation therapy during pregnancy, delivery and the post-delivery period of such patients has also been presented.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
8/41. Chorea in a pregnant woman with rheumatic mitral stenosis.chorea gravidarum is a rare movement disorder of pregnancy with a broad differential diagnosis. Although often a benign condition, it may indicate underlying acute rheumatic fever, antiphospholipid antibody syndrome or a hypercoagulable state. However, now that rheumatic fever is rare in western countries, chorea gravidarum occurs most commonly in patients with chronic rheumatic heart disease. Heightened awareness of chorea gravidarum and the morbidity of the often associated rheumatic heart disease, particularly in immigrants from developing countries, is essential for early diagnosis and effective management. A case of chorea gravidarum in a woman with rheumatic mitral stenosis is described. The diagnostic approach, pathophysiology and management of this rare condition are discussed.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
9/41. Treatment of severe mitral stenosis in pregnancy using multi-track mitral balloon dilatation: case report.A case of 31-year old pregnant lady with severe mitral stenosis who benefited tremendously from multi-track balloon valvotomy is presented. She had history of cardiorespiratory arrest during delivery in the previous pregnancy and presented to the obstetrician pregnant again and symptomatic. After detailed cardiac evaluation, she was managed medically up to end of second trimester and then percutaneous balloon mitral valvotomy was done under fluoroscopy with total abdominal and pelvic shielding. The results were dramatic both in terms of haemodynamic changes and in the clinical outcome. The patient went on to give birth to a normal healthy baby. This case illustrates current management approach of mitral stenosis in pregnancy.- - - - - - - - - - ranking = 3keywords = pregnancy (Clic here for more details about this article) |
10/41. Percutaneous balloon mitral valvotomy in pregnancy using the Inoue balloon catheter.Percutaneous balloon mitral valvotomy (PBMV) using the Inoue balloon catheter was performed successfully in 2 patients with severe mitral stenosis refractory to medical treatment during pregnancy. Because of its unique design and ease of manipulation, we recommend the Inoue balloon catheter for performing PBMV in selected patients with mitral stenosis during pregnancy, as procedure and fluoroscopy times can be significantly shortened.- - - - - - - - - - ranking = 3keywords = pregnancy (Clic here for more details about this article) |
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