Published Paper Details:

Objective: This work aims at studying the indications and immediate to long term results of percutaneous mitral commisurotomy during pregnancy. Methods: A retrospective study of 246 mitral valve dilations performed during pregnancy from 1997 to 2018 in the Cardiology A department, Ibn Sina Teaching hospital Rabat. We analyzed clinical, echocardiographic and hemodynamic data before and after PMC: Results: Our patients� mean age was 28 � 5.2 years and the gestational age 28.1 � 4 weeks of amenorrhea. Mitral stenosis was discovered during pregnancy in 40% of cases and all 246 patients were primiparous. 94% of our patients were symptomatic (NHYA stages III to IV). 85% of patients had sinus rhythm. On cardiac ultrasound imaging, mitral stenosis was severe in all our patients: mean surface area of 0.8cm� and ? 1cm� in 85% of our cases; 90% of our patients had Wilkins� score of 8 � 9. Mean transvalvular gradient was high (21.4mmHg) and most of our patients had pulmonary hypertension (mean Pulmonary Artery systolic pressure 71mmHg). The procedure had 98% success rate with immediate regression of symptoms to NYHA stages I to II in 95% cases. After PMC, pregnancy reached full term in 95% of our patients with low fetal morbimortality and delivery in good conditions, mostly vaginal (85% of our cases). Conclusion: PMC is the ideal treatment for severe symptomatic mitral stenosis during pregnancy, yielding excellent results with very few complications. It leads to a clear regression of symptoms and improves hemodynamic parameters as well as pregnancy and delivery conditions. When indicated, PMC should be performed in a reference centre.