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Percutaneous Balloon Mitral Valvuloplasty pada Wanita Hamil 22 Minggu akibat Mitral Stenosis Berat dengan Penyulit Gagal Jantung Kongestif dan Hipertensi Pulmonal berat (Percutaneous Balloon Mitral Valvuloplasty Treatment Conducted at 22nd Weeks Pregnancy Woman With Congestive Heart Failure and Pulmonary Hypertension)

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Background: Congestive Heart Failure (CHF) in pregnancy is a critical condition due to its high maternal and fetal mortality. One of the leading cause of CHF is mitral stenosis related with rheumatic heart disease. Normally this condition requires pregnancy termination, however percutaneous balloon mitral valvuloplasty (PBMV) showed is the most frequently encountered rheumatic valve lesion. A variety of pregnancy-associated cardiovascular changes often exacerbate the signs and svrriptorns ofvalve lesions.
Case : A 36 year, 22nd week pregnancy woman with dyspnea referred to Dr. Kariadi hospital. She was diagnosed congestive heart failure (CHF) based on New York Heart Association (NYHA) IV class, with severe pulmonary hypertension (PH) and moderate to severe mitral stenosis (MS) et causa rheumatic heart disease (RHD). Termination of pregnancy was recommended to save the mother, but the patient refused. To relieve CHF symptoms and reduce the degree of PH, PBMV was done. Meanwhile Trans Esophageal Echocardiography (TEE) was conducted to examine thrombus and mitral regurgitation, and it revealed suggested rheumatic heart disease moderate-severe mitral stenosis dan tricuspid regurgitation, mild aortic regurgitation, and severe pulmonary hypertension.
Discussion : New technique development in the mitral valve disease is percutaneous balloon mitral valvuloplasty for mitra I stenosis. To use PBMV in pregnant patients should be considered due to the safety of the mother and fetus. The comorbidity such as the severity of mitral stenosis, status of thrombus, heart failure and pulomanary hypertension sould be considered , weighing the risks and benefits in each individual, to ~ure the survival of the mother and improve the welfare of the fetus. Taking PBMV as the option of treatment, the condition of patient including severity and complication had to be considered carefully.
Conclusion: PBMV treatment on pregnant woman suffering from CHF and pulmonary hypertension can be done after considering the severity of the disease and complication.

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Detail Information

Series Title

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Call Number

Medica Hospitalia: Journal of Clinical Medicine,

Publisher

Semarang : Medica Hospitalia-Dr. Kariadi Hospital., 2012

Collation

5p

Language

ISBN/ISSN

2301-4369

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Carrier Type

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Edition

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Subject(s)

pregnancy
heart failure, congestive
HYPERTENSION, POLMUNARY

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