Balloon aortic valvuloplasty in pregnancy with severe aortic stenosis and infective endocarditis

Vinotha; Ruby Jose

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Balloon aortic valvuloplasty in pregnancy with severe aortic stenosis and infective endocarditis

机译：妊娠合并严重主动脉瓣狭窄和感染性心内膜炎的球囊主动脉瓣膜成形术

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Twenty seven year old lady, previously diagnosed to have aortic stenosis, presented to the obstetric outpatient department at 19 weeks of gestation with fever and breathlessness, NYHA class 4, for one week. Two D Echo revealed left ventricular hypertrophy, a severely stenosed, calcified bicuspid aortic valve, with vegetations on aortic and mitral valves and severe mitral regurgitation. Blood cultures grew nutrionally variant streptococci and she was treated with crystalline penicillin and gentamicin. She stabilised clinically by 21 weeks, by which time, the risk of termination of pregnancy was comparable to continuing the pregnancy. She underwent balloon aortic valvuloplasty. Post balloon aortic valvuloplasty, she was stable. At 34+2 weeks, she underwent emergency LSCS, the indication being intrauterine growth restriction with fetal compromise and breech presentation. She delivered a baby girl, 1.6 kg, Apgar 9 & 10. Our case report highlights the fact that a timely, balloon aortic valvuloplasty can be life saving for patients with pregnancy complicated by severe aortic stenosis and infective endocarditis.

机译：先前被诊断出患有主动脉瓣狭窄的二十七岁女士，在妊娠19周伴有发烧和呼吸困难，NYHA 4级，就诊于产科门诊，为期一周。两个回声显示左心室肥大，严重狭窄，钙化的二尖瓣主动脉瓣，主动脉瓣和二尖瓣上有植物，严重的二尖瓣反流。血液培养物在营养上变异了链球菌，并接受了结晶青霉素和庆大霉素的治疗。她的临床症状稳定了21周，到那时，终止妊娠的风险与继续妊娠相当。她接受了球囊主动脉瓣膜成形术。球囊主动脉瓣成形术后，她稳定。在34 + 2周时，她接受了紧急LSCS，这表明宫内生长受到限制，并伴有胎儿折衷和臀位。她分娩了一个女婴，体重为1.6公斤，Apgar 9＆10。我们的病例报告强调了这样一个事实，即及时进行球囊主动脉瓣膜成形术可以挽救妊娠合并严重主动脉瓣狭窄和感染性心内膜炎的患者的生命。

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《International Journal of Reproduction, Contraception, Obstetrics and Gynecology》 |2012年第1期|共3页
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Vinotha; Ruby Jose;
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Balloon aortic valvuloplasty in pregnancy with severe aortic stenosis and infective endocarditis

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