Long term outcome of balloon mitral commissurotomy during pregnancy : a prospective physical and mental evaluation of babies

Aim: The immediate and long-term results of balloon mitral commissurotomy(BMC) during pregnancy were evaluated in patients and in their babies looking for radiation side effects. Methods and results: Sixty one patients (mean age: 28.5±5.0 years) had BMC at a mean age of gestation of 26.8±5.5 weeks. The procedure was successful in all patients except in one who had a severe mitral regurgitation and subsequent mitral valve replacement(MVR). All patients delivered at term vaginally in 58 (95.1%) cases. There was only one death in a patient who delivered at home. At a mean follow-up of 66.8±36.0 months, 4 patients had MVR, the remaining were in NYHA class I/II Restenosis was found in 4 (7.2%) patients. The 6 babies (two gemellar pregnancies) had a normal weight of birth except of one case of hypotrophy. At a mean follow-up of 64.5±32.5 months, two babies died, 1 had hypotrophy, 2 had microcephaly, 8 had an IQ < 70 but none had a severe mental retardation (IQ ≤34). None of these events were radiation related. Conclusion: BMC is the procedure of choice in pregnant patients with mitral stenosis. No late radiation side effects were observed in children but longer follow-up is required.