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ASSA14-04-05  The Radiation protection of pregnancy women with rheumatic heart disease combine with mitral stenosis undergoing balloon valvuloplasty
  1. C Zhang-qiang,
  2. Lang,
  3. W Hong,
  4. L Lin-Xiang,
  5. Y Qiu-Lin,
  6. L Heng-li,
  7. L Hua-Tai
  1. Department of Cardiology, Jiangxi Provincal People's Hospital, Nanchang, Jiangxi, 330006, China

Abstract

Objective To explore the radiation protection of pregnancy women with rheumatic heart disease combined with mitral stenosis undergoing balloon valvuloplasty, PBMV).

Method 30 pregnancy women suffered from rheumatic heart disease with mitral stenosis selected in our hospital from March 2004 to December 2011. 20 cases of moderate stenosis, 10 cases of severe stenosis. mitral valve area of (an average of 0.9 ± 0.4 cm2). 5–9 months of pregnancy. 15 cases of patients with recurrent left ventricular failure, three cases of severe hemoptysis Before intervention operative intravenous use of diuretics to reduce heart failure symptoms, and during procedure each patient's abdomen, waist and back cushioned with anti-radiation lead pads, as far as possible to reduce exposure time and operation time. Incremental approach to expanding with contrast agent. The end of expansion: left atrial pressure decreased more than 50%, or the average left atrial pressure below 15 mmHg, the rumbling murmur in mitral valve area disappeared or significantly reduced.

Results In 30 cases of pregnant patients after balloon dilation, the average left atrial pressure significantly reduced (p < 00.01). Left atrioventricular valve MTPG significantly reduced (p < 00.01). Pulmonary artery pressure decreased significantly (p < 00.01). mitral valve area expanded significantly (p < 0.01), left atrial diameter significantly reduced (p < 00.01) compared with the preoperative, Chest tightness, shortness of breath, difficulty breathing and other symptoms were relieved, cardiac function significantly improved. Followed up for 3 months to 6 years (mean 52 ± 15 months). Under closely supervision, three cases of full-term birth, 27 cases of caesarean section, no abnormal fetus and serious complications occurred.

Conclusion The patients with severe rheumatic mitral stenosis combined with late pregnancy prone to acute left ventricular failure, and if not promptly treated, easy to endanger the life of maternal and infant. Under the X-ray strictly shielding, percutaneous balloon dilatation is an effective treatment for pregnant patients combined with severe rheumatic mitral stenosis, it can reduce symptoms and improve quality of life as well as improve the prognosis of pregnancy, at the same time provides an opportunities and valuable time for termination of pregnancy.

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