PMID- 28384909
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2249-782X (Print)
IS  - 0973-709X (Electronic)
IS  - 0973-709X (Linking)
VI  - 11
IP  - 2
DP  - 2017 Feb
TI  - Immediate Outcome of Balloon Mitral Valvuloplasty with JOMIVA Balloon during 
      Pregnancy.
PG  - OC18-OC20
LID - 10.7860/JCDR/2017/24234.9345 [doi]
AB  - INTRODUCTION: Rheumatic mitral stenosis is the most common Valvular Heart Disease 
      encountered during pregnancy. Balloon Mitral Valvuloplasty (BMV) is one of the 
      treatment option available if the symptoms are refractory to the medical 
      management and the valve anatomy is suitable for balloon dilatation. BMV with 
      Inoue balloon is the most common technique being followed worldwide. Over the 
      wire BMV is a modified technique using Joseph Mitral Valvuloplasty (JOMIVA) 
      balloon catheter which is being followed in certain centres. AIM: To assess the 
      immediate post procedure outcome of over the wire BMV with JOMIVA balloon. 
      MATERIALS AND METHODS: Clinical and echocardiographic parameters of pregnant 
      women with significant mitral stenosis who underwent elective BMV with JOMIVA 
      balloon in our institute from 2005 to 2015 were analysed retrospectively. 
      Severity of breathlessness (New York Heart Association Functional Class), and 
      duration of pregnancy was included in the analysis. Pre procedural 
      echocardiographic parameters which included severity of mitral stenosis and 
      Wilkin's scoring were analysed. Clinical, haemodynamic and echocardiographic 
      outcomes immediately after the procedure were analysed. RESULTS: Among the 
      patients who underwent BMV in our Institute 38 were pregnant women. Twenty four 
      patients (63%) were in New York Heart Association (NYHA) Class III. All of them 
      were in sinus rhythm except two (5%) who had atrial fibrillation. Thirty four 
      patients (89.5%) were in second trimester of pregnancy at the time of 
      presentation and four (10.5%) were in third trimester. Echocardiographic analysis 
      of the mitral valve showed that the mean Wilkin's score was 7.3. Mean mitral 
      valve area pre procedure was 0.8 cm(2). Mean gradient across the valve was 18 
      mmHg. Ten patients (26.5%) had mild mitral regurgitation and none had more than 
      mild mitral regurgitation. Thirty six patients had pulmonary hypertension as 
      assessed by tricuspid regurgitation jet velocity. All of them underwent BMV with 
      JOMIVA balloon. Post procedure mean mitral valve area was 1.7 cm(2) as assessed 
      by echocardiography. Post procedure mean gradient across the mitral valve as 
      assessed by echocardiography was 5 mmHg. Two patients had moderate to severe 
      mitral regurgitation after the procedure and the rest had either no mitral 
      regurgitation or mild mitral regurgitation after the procedure. None of the 
      patients warranted mitral valve replacement after BMV. No patients had any 
      manifestations of systemic embolism like cerebrovascular accident or limb 
      ischemia after the procedure. None of the patients had preterm delivery or 
      adverse fetal outcome during index hospitalisation. CONCLUSION: Over the wire BMV 
      is safe and effective method during pregnancy. The results are comparable to that 
      of Inoue technique. BMV offers a good symptomatic improvement in pregnant women 
      presenting with symptoms of pulmonary congestion because of Rheumatic mitral 
      stenosis.
FAU - Rathakrisnnan, Shanmuga Sundaram
AU  - Rathakrisnnan SS
AD  - Associate Professor, Department of Cardiology, PSG Institute of Medical Sciences 
      and Research , Coimbatore, Tamil Nadu, India .
FAU - Ramasamy, Ramona
AU  - Ramasamy R
AD  - Resident, Department of Cardiology, PSG Institute of Medical Sciences and 
      Research , Coimbatore, Tamil Nadu, India .
FAU - Kaliappan, Tamilarasu
AU  - Kaliappan T
AD  - Associate Professor, Department of Cardiology, PSG Institute of Medical Sciences 
      and Research , Coimbatore, Tamil Nadu, India .
FAU - Gopalan, Rajendiran
AU  - Gopalan R
AD  - Professor, Department of Cardiology, PSG Institute of Medical Sciences and 
      Research , Coimbatore, Tamil Nadu, India .
FAU - Palanimuthu, Ramasmy
AU  - Palanimuthu R
AD  - Associate Professor, Department of Cardiology, PSG Institute of Medical Sciences 
      and Research , Coimbatore, Tamil Nadu, India .
FAU - Anandhan, Premkrishna
AU  - Anandhan P
AD  - Assistant Professor, Department of Cardiology, PSG Institute of Medical Sciences 
      and Research , Coimbatore, Tamil Nadu, India .
LA  - eng
PT  - Journal Article
DEP - 20170201
PL  - India
TA  - J Clin Diagn Res
JT  - Journal of clinical and diagnostic research : JCDR
JID - 101488993
PMC - PMC5376835
OTO - NOTNLM
OT  - Mitral valve
OT  - Stenosis
OT  - Valvular heart disease
EDAT- 2017/04/08 06:00
MHDA- 2017/04/08 06:01
PMCR- 2017/04/01
CRDT- 2017/04/08 06:00
PHST- 2016/09/23 00:00 [received]
PHST- 2016/12/08 00:00 [accepted]
PHST- 2017/04/08 06:00 [entrez]
PHST- 2017/04/08 06:00 [pubmed]
PHST- 2017/04/08 06:01 [medline]
PHST- 2017/04/01 00:00 [pmc-release]
AID - 10.7860/JCDR/2017/24234.9345 [doi]
PST - ppublish
SO  - J Clin Diagn Res. 2017 Feb;11(2):OC18-OC20. doi: 10.7860/JCDR/2017/24234.9345. 
      Epub 2017 Feb 1.