Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Rheumatic mitral stenosis (MS) is prevalent in developing countries. Poorly tolerated during pregnancy, MS is often requiring urgent intervention. OBJECTIVES: This study aimed to evaluate immediate and long-term outcomes after percutaneous (PMC) in pregnant women. METHODS: Observational retrospective study of pregnant women who underwent PMC for severe MS between January 2008 and December 2018. Primary endpoint was procedural success (mitral valve area > 1.5 cm²) without complications. RESULTS: 39 patients. Mean age 34.2±5.1 years. Mean gestational age 28.2±4.9 weeks. PMC was successful in 37 patients (94.8%). There was no maternal mortality. Two procedures failed (1 transseptal puncture failure and 1 severe traumatic mitral regurgitation requiring emergent surgery). If successful, PMC allowed the pursue of pregnancy until full term and vaginal delivery in 36 (92.3%) and 20 (51.3%) patients, respectively. One in utero foetal demise and one neonatal death occurred. At 56.1-month, after exclusion of three patients with prompt surgical valve replacement, there were 7 cases of mitral restenosis (19.4%) with Wilkins score >8, suboptimal result (valve area between 1.5 and 1.8 cm²) and incomplete bicommissural splitting as predictive factors. All babies maintained normal growth and development. CONCLUSION: This study confirmed effectiveness and safety of PMC during pregnancy when performed by an experienced team with a procedural success of 94.8% but at the cost of a restenosis rate of 19.4% at 56.1 months. These were predicted, in addition to Wilkins score, by a suboptimal but accepted immediate result of the procedure, still allowing a step forward.
Source: La Tunisie Médicale
Authors: Selim Boudiche, Abdeljelil Farhati, Sofien Haboubi, Manel Abbassi, Mohamed Chedly, Faten El Ayech Boudiche, Zeynab Jebbari, Amal Ben Salem, Khaled Ezzaouia, Boutheina Besbes, Foued Daly, Rim Ben Rejeb, Dhekra Sebki, Ines Bounaoues, Mehrez Gouader, Fathia Mghaieth, Sana Ouali, Noureddine Larbi, Manel Ben Halima, Mohamed Sami Mourali
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7134886467