Life Of Mother And Fetus Saved By Cardiac Procedure Performed At The Hearth Hospital Of New Jersey
At Saint Barnabas Medical Center

Mitral valvularplasty, a catheter-based procedure used to open a fused heart valve, was performed earlier this year at The HEART HOSPITAL of New Jersey at Saint Barnabas Medical Center on a patient in her second trimester of pregnancy. Thanks to the collaboration of a team of cardiologists and high-risk obstetricians, Helena Pais, 33, of Union was able to bring her pregnancy to full term and give birth to a healthy baby girl.

“Mitral valvularplasty is not an uncommon procedure, but performing it on a pregnant patient is very rare,” says Gary J. Rogal, M.D., Chief of Cardiology of the Saint Barnabas Health Care System. “In this case the symptoms of rheumatic heart disease were so severe that the lives of both the mother and infant were at risk.”

Referred to cardiologists at Saint Barnabas’ HEART HOSPITAL of New Jersey early in her pregnancy because of severe shortness of breath and coughing, Ms. Pais was diagnosed with mitral valve stenosis. Most likely the result of an infection she had as a child, one of the valves in her heart was partially fused. “Mitral valve stenosis is challenging to diagnose in a patient who is pregnant, because of the various circulatory changes that occur during pregnancy,” says Dr. Rogal.

In consultation with the team of obstetricians at Saint Barnabas Medical Center’s Division of Maternal-Fetal High Risk Medicine who were caring for Ms. Pais, Dr. Rogal recommended medications to slow her heart and reduce the volume of blood. Yet, by the second trimester she began showing symptoms of heart failure. The damaged valve was blocking blood flow through her heart and pressure was building in her lungs.

“As the pregnancy progressed I got worse,” recalls Ms. Pais.“I couldn’t lie down or walk up even a few stairs. It was very scary.” The cardiologists and obstetricians agreed that unless something was done both lives were in danger.

“Only in a tertiary care heart hospital can you find the skill, experience and technology necessary to address a complicated case like this one,” emphasizes Dr. Rogal.

A Team Effort Achieves Success
Interventional cardiologists were joined by cardiac anesthesiologists and cardiac surgeons, as well as a team of high-risk obstetricians and nurses who monitored the status of the fetus during the entire procedure. A slender wire and balloon were threaded from the patient’s groin into her heart, through the chamber wall and into the partially fused valve. Once positioned in the valve, the balloon was inflated, opening the two leaves of the fused valve.

“There were several critical risks,” explains Dr. Rogal. “Anesthesia can trigger uterine contractions, and inflating the balloon for several seconds stopped all blood flow to both mother and infant.” With careful attention to these risks, the procedure was successfully completed.

Following the procedure Ms. Pais felt better almost immediately. She was able to carry the pregnancy to full term and a healthy Anamaria Pais was born on April 27. Mom says she feels better than she did before her pregnancy. “I was always tired, but I blamed it on my thyroid. Now I know it must have been my heart.”

[ Back to Newsletter Index ]