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In which trimester do patients with mitral stenosis usually become symptomatic?

In which trimester do patients with mitral stenosis usually become symptomatic?

Patients usually become symptomatic in the second trimester of pregnancy, when blood volume increases significantly and increases pulmonary pressures. As the blood volume diminishes late in the third trimester, the symptoms might slightly improve.

Which surgical procedures are used to treat mitral stenosis?

Closed commissurotomy

· Closed mitral valvotomy - involves the use of mechanical dilators, inserted through the apex of the left ventricle. It is complicated by mitral regurgitation, systemic embolization and restenosis.

· Balloon valvuloplasty (a form of closed commissurotomy) - percutaneous trans-septal balloon mitral valvotomy (or valvuloplasty). Remember, percutaneous balloon dilatation of the mitral valve is a useful option in patients who are unable to undergo cardiac surgery, as in late pregnancy or when too ill (severe respiratory disease, non-mitral cardiac disease, multiorgan failure).

Open commissurotomy

Requires cardiopulmonary bypass and allows surgical repair of the valve under direct vision, resulting in more effective and safer valvotomy than the closed procedure.

Valve replacement

Entails risks including thromboembolism, endocarditis and primary valve failure.

Postimet e fundit






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