Cardiac tamponade after mitral valvuloplasty in a pregnant woman

Abstract

Mitral stenosis during pregnancy poses a substantial risk, both to the mother and foetus. Percutaneous mitral valvuloplasty performed during pregnancy has been associated with an excellent shortterm outcome, with reduction of both maternal and foetal complications. We report a case of percutaneous mitral valvuloplasty in a pregnant woman with severe rheumatic mitral stenosis and impending pulmonary oedema. The procedure was performed through a right femoral vein approach, employing the multitrack technique, using 2 balloons (20 and 18 mm). Inadvertently, the procedure was complicated by cardiac tamponade. Despite a stable haemodynamic condition, and absence of echocardiographic signs of chamber collapse, haemodynamic monitoring revealed an equal value for right atrial, left atrial and left ventricular end-diastolic pressure. Immediately, adequate pericardiocentesis was performed and post-procedural echocardiography revealed a mitral valve area of 2.0 cm², with no mitral regurgitation. Eventually, the pregnancy was continued and ultimately, the patient gave birth to a healthy full-term baby.

• Percutaneous mitral valvuloplasty
• cardiac tamponade
• pregnancy