Pulmonary Balloon Valvuloplasty during Pregnancy

Abstract

Women with valvular heart disease have an increased risk of adverse outcomes in pregnancy; however, with appropriate evaluation and treatment, most women can successfully bear healthy children. During pregnancy, pulmonary stenosis is generally well tolerated in the absence of other haemodynamically significant lesions. We present a case of a multiparous woman,who is pregnant with her sixth child, with a severe pulmonary stenosis. She presented with exertional chest pain and dyspnea. She was managed successfully with balloon valvuloplasty.

Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

“…167 Pulmonary balloon valvuloplasty may be performed successfully during pregnancy with expected improvement in the degree of stenosis. 172 Transcatheter occlusion of various shunts can be performed with transcatheter techniques but is rarely indicated during pregnancy. Transcatheter closure of atrium-level shunts could be considered in pregnant women with cyanosis because of right-to-left shunting at the atrial level and poor fetal growth.…”

Fetal cardiac interventions: clinical and experimental research

“…[ 41 ] performed pulmonary valvuloplasty on four fetuses with PA/IVS at a mean gestational age of 25 weeks; they achieved 100% technical success and observed postinterventional developmental and hemodynamic improvements. Successful fetal pulmonary valvuloplasties with critical pulmonary valve stenosis at midgestation have been sporadically reported, thus illustrating the immediate hemodynamic improvement and postinterventional event-free survival [ 42 – 44 ]. In one of these studies, Polat et al .…”

A Importância Do Planejamento Familiar, Do Acompanhamento Médico E Da Prática De Exercícios Na Gestante Cardiopata

“…Se sintomática, a valvoplastia percutânea é a melhor opção de tratamento, registrando melhores resultados e podendo ser realizada em qualquer idade gestacional. Complicações não cardíacas, como distúrbios hipertensivos, prematuridade e complicações tromboembólicas, estão ocasionalmente associadas à estenose pulmonar 44,45 .…”

“…Para regurgitação grave, é necessário avaliar os riscos e benefícios das intervenções cirúrgicas, assim como o momento adequado para a cirurgia em relação à gravidez. Porém, pacientes assintomáticas com boa função ventricular podem presumivelmente tolerar bem a gravidez, apesar da regurgitação grave 44,45 .…”