RESUMO
Introducción: La segmentectomía lateral izquierda es el procedimiento más empleado para la cirugía del donante en trasplante hepático con donante vivo adulto-pediátrico (THDVA-P), y ha demostrado ser seguro y reproducible. Sin embargo, la información aún es escasa respecto al abordaje laparoscópico. Objetivo: El objetivo de este artículo es dar a conocer los resultados posoperatorios de la segmentectomía lateral izquierda laparoscópica (SLI-L) para THDVA-P. Materiales y Método: Realizamos un estudio retrospectivo, observacional, de un solo centro, Hospital del Salvador; con vasta experiencia en trasplante hepático y en resecciones hepáticas laparoscópicas. Se ofreció realizar el procedimiento de SLI-L para la cirugía del donante vivo. Se describe la técnica quirúrgica y los resultados posoperatorios de los donantes. Resultados: Entre abril de 2015 y enero de 2021, 36 pacientes, 25 de ellos hombres, fueron sometidos a SLI-L. El 86% eran madre o padre del receptor, con una mediana de 30 años (19-45). Mediana de tiempo operatorio de 360 min (240-480). Hubo conversión en un caso debido a sangrado venoso de difícil manejo y en dos oportunidades se utilizó técnica mano asistida por la misma causa. Morbilidad Clavien-Dindo III en un paciente debido a fuga biliar precoz, manejada con prótesis vía colangiopancreatografía retrógrada endoscópica exitosamente. La mediana de hospitalización fue de 4 días (3-12) y no hubo mortalidad. Conclusión: La SLI-L ha evolucionado, desde un procedimiento innovador hasta convertirse en el actual procedimiento estándar para THDVA-P. Los buenos resultados en términos de morbimortalidad sugieren que podría ser una técnica segura y reproducible en contextos similares al del centro.
Introduction: Living donor left lateral sectionectomy is a well-established alternative in cadaveric donor pediatric liver transplantation. This procedure has proven to be safe and reproducible. However, laparoscopic approach is still under development and evidence of its feasibility is limited. Aim: The aim of this article is to present the surgical technique and postoperative outcomes of the cases of laparoscopic left lateral sectionectomy performed in this center. Materials and Method: A retrospective, observational, single center study was conducted in Hospital del Salvador. From 04/2015 - 01/2021 laparoscopic left lateral sectionectomy was offered for donor surgery. We present the surgical technique, perioperative care, and early postoperative outcomes in donors. Results: This series includes 36 patients, 25 (69%) of them were males. A total of 31 (86%) donors were mother or father of the recipient. Median age of donors was 30 years (19-45), median operative time was 360 min (240-480). All the patients underwent laparoscopic left lateral sectionectomy. Conversion was necessary in one case due to difficult management of a venous bleeding. Clavien-Dindo Morbidity III, in one patient who required endoscopic retrograde cholangiopancreatography due to an early bile leak. Median hospitalization was 4 days (3-14). There was no mortality. Conclusion: Laparoscopic left lateral sectionectomy has proven to be safe and reproducible. This technique has evolved from an innovative procedure to become the current standard of practice in our center, with excellent results in terms of morbidity and mortality.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Mastectomia Segmentar/métodos , Transplante de Fígado/métodos , Laparoscopia/métodos , Período Pós-Operatório , Resultado do Tratamento , Doadores VivosRESUMO
Introduction: The SARS-CoV-2 pandemic has been affecting the world since January 2020. Although its pathogenesis is primarily directed to the respiratory tract, other organs may be affected, including the nervous system. It has also been shown that the social context (confinement, lack of treatment) has affected neurological patients during this period. The aim of the study it was to assess the subjective worsening of neurological/psychiatric diseases in the context of the SARS-Cov-2 pandemic. Methods: Three groups of neurological/psychiatric patients were included: Patients who had symptomatic COVID-19 (nâ¯=â¯89), patients who had asymptomatic COVID-19 (nâ¯=â¯40), and a control group (nâ¯=â¯47), consisting of neurological/psychiatric patients without a history of SARS-Cov-2 infection. Results: 30.7% of the included individuals considered that their basal pathology had worsened during the study period. This feeling was significantly more frequent (Pâ¯=â¯0.01) in patients with symptomatic COVID-19 (39.3%) than in patients of the other 2 groups (21.8%). Worsening was not related to the severity of COVID-19. The neurological conditions that significantly worsened after COVID-19, comparing symptomatic COVID-19 with the other 2 groups, were demyelinating and degenerative diseases. Conclusions: These results confirmed the impact of the SARS-Cov-2 pandemic on patients with neurological/psychiatric diseases. Confinement, lack of medical care, and the threat of diagnosis are surely contributing factors. Although the finding of a higher frequency of worsening in symptomatic COVID-19 patients may be related to greater anxiety/depression in this group of patients, we cannot exclude the role of direct affectation of the nervous system by the virus or damage due to neuroinflammation.
Introducción: La pandemia por SARS-CoV-2 afecta al mundo desde enero de 2020. Aunque su patogenia se dirige principalmente a las vías respiratorias, otros órganos pueden verse afectados, incluido el sistema nervioso. También se ha demostrado que el contexto social (confinamiento, falta de tratamiento) ha afectado a los pacientes neurológicos durante este periodo. El objetivo del estudio fue evaluar el empeoramiento subjetivo de enfermedades neurológicas/psiquiátricas en el contexto de la pandemia por SARS-Cov-2. Métodos: Se incluyeron tres grupos de pacientes neurológicos/psiquiátricos: pacientes que tenían COVID-19 sintomático (nâ¯=â¯89), pacientes que tenían COVID-19 asintomático (nâ¯=â¯40) y un grupo control (nâ¯=â¯47), formado por pacientes neurológicos/psiquiátricos sin antecedentes de infección por SARS-Cov-2. Resultados: El 30,7% de los individuos incluidos consideró que su patología basal había empeorado durante el período de estudio. Este sentimiento fue significativamente más frecuente (pâ¯=â¯0,01) en pacientes con COVID-19 sintomático (39,3%) que en pacientes de los otros 2 grupos (21,8%). El empeoramiento no estuvo relacionado con la gravedad de COVID-19. Las condiciones neurológicas que empeoraron significativamente después de la COVID-19, comparando la COVID-19 sintomática con los otros 2 grupos, fueron las enfermedades desmielinizantes y degenerativas. Conclusiones: estos resultados confirmaron el impacto de la pandemia del SARS-Cov-2 en pacientes con enfermedades neurológicas/psiquiátricas. El encierro, la falta de atención médica y la amenaza del diagnóstico son seguramente factores contribuyentes. Aunque el hallazgo de una mayor frecuencia de empeoramiento en pacientes sintomáticos de COVID-19 puede estar relacionado con una mayor ansiedad/depresión en este grupo de pacientes, no podemos excluir el papel de la afectación directa del sistema nervioso por el virus o el daño por neuroinflamación.
RESUMO
BACKGROUND: Increased vascularity of the airway mucosa in asthma potentially increases heat loss in the airways. OBJECTIVE: To determine if the inflamed airways of subjects with uncontrolled asthma show increased exhaled breath temperature (EBT). PATIENTS AND METHODS: In 100 patients with persistent asthma and 50 healthy volunteers, we measured lung function by post-bronchodilator forced spirometry, the asthma control test (ACT) and EBT. RESULTS: Patients with asthma, of whom 49 (49%) were female, with a mean (± standard error of the mean) age of 44 (±17) years and a predicted forced expiratory volume in one second of 71% (±16), had a significantly increased EBT, particularly those with uncontrolled asthma (n = 50, ACT ≤ 19, EBT 34.9 ± 0.8°C), compared to patients with controlled asthma (n = 50, ACT ≥ 20, EBT 33.7 ± 0.8°C) and healthy volunteers (n = 50, EBT 33.2 ± 0.2°C, P < 0.001). CONCLUSION: We observed a higher temperature on exhaled breath in subjects with uncontrolled asthma than in subjects with controlled asthma and healthy controls. The increase in exhaled breath temperature may be a proxy for a raised airway inflammatory state in asthma patients.
Assuntos
Asma/fisiopatologia , Inflamação/fisiopatologia , Mucosa Respiratória/patologia , Adulto , Temperatura Corporal , Testes Respiratórios/métodos , Broncodilatadores/farmacologia , Estudos de Casos e Controles , Expiração , Feminino , Volume Expiratório Forçado , Humanos , Inflamação/etiologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Mucosa Respiratória/irrigação sanguínea , Espirometria , Adulto JovemRESUMO
Acute pancreatitis is a disease that presents heterogeneously with varying severity depending on pancreatic parenchyma and peripancreatic fat. The aim of this publication is to present the nomenclature in use in the different collections that develop in the evolution of acute pancreatitis, and management options of these collections, focusing on the management of infected pancreatic necrosis; emphasizing the benefits, results and limitations of each technique and describing some techniques under development.
La pancreatitis aguda es una enfermedad que se presenta en forma heterogénea con distinta gravedad según el compromiso del parénquima pancreático y de la grasa peripancreática. El objetivo de esta publicación es dar a conocer la nomenclatura en uso en las distintas colecciones que se manifiestan en la evolución de la pancreatitis aguda y las opciones de manejo de estas colecciones, enfocándose en el manejo de la necrosis pancreática infectada; enfatizando las ventajas, resultados y limitaciones de cada técnica, además de describir algunas técnicas en desarrollo.
Assuntos
Humanos , Drenagem/métodos , Necrose/terapia , Pancreatite Necrosante Aguda/terapia , Necrose/cirurgia , Pancreatite Necrosante Aguda/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodosRESUMO
La gran cantidad de información que surge de las investigaciones científicas, hace que sea muy difícil mantenerse al día con los adelantos que un clínico requiere en su práctica diaria. Este artículo describe un nuevo paradigma para la práctica clínica que permite utilizar la información obtenida a través de un proceso de apreciación crítica en el cuidado de los pacientes, lo que se conoce como odontología basada en la evidencia
Assuntos
Odontologia/tendências , Medicina Baseada em Evidências/tendências , Prática Profissional/tendências , Armazenamento e Recuperação da Informação/métodos , Bases de Dados Bibliográficas/tendências , Pesquisa em Odontologia/métodos , Participação do Paciente/métodos , Padrões de Prática Odontológica/tendênciasRESUMO
Native and wild-type recombinant human liver arginases (EC 3.5.3.1) were photoinactivated by Rose bengal, and protection was afforded by the competitive inhibitor l-lysine. The dissociation constant for the enzyme-protector complex was essentially equal to the corresponding K(i) value. Upon mutation of His141 by phenylalanine, the enzyme activity was reduced to 6-10% of wild-type activity, with no changes in K(m) for arginine or K(i) for l-lysine or l-ornithine. The subunit composition of active enzyme was not altered by mutation, but the mutant H141F was markedly more sensitive to trypsin inactivation and completely insensitive to inactivation by diethyl pyrocarbonate (DEPC) and photoinactivation. Species with histidine groups blocked with DEPC were also insensitive to photoinactivation. We conclude that His141, which is the target for both inactivating procedures, is not involved in substrate binding, but plays a critical, albeit not essential role in the hydrolysis of enzyme-bound substrate.
Assuntos
Arginase/metabolismo , Histidina/genética , Fígado/enzimologia , Arginase/antagonistas & inibidores , Arginase/genética , Arginase/efeitos da radiação , Arginina/metabolismo , Domínio Catalítico , Dietil Pirocarbonato/farmacologia , Humanos , Luz , Lisina/metabolismo , Mutagênese Sítio-Dirigida , Ornitina/metabolismo , Rosa Bengala/farmacologiaRESUMO
Agmatinase (agmatine ureohydrolase, EC 3.5.3.11) from Escherichia coli was inactivated by diethyl pyrocarbonate (DEPC) and illumination in the presence of Rose bengal. Protection against photoinactivation was afforded by the product putrescine, and the dissociation constant of the enzyme-protector complex (12 mM) was essentially equal to the K(i) value for this compound acting as a competitive inhibitor of agmatine hydrolysis. Upon mutation of His163 by phenylalanine, the agmatinase activity was reduced to 3-5% of wild-type activity, without any change in K(m) for agmatine or K(i) for putrescine inhibition. The mutant was insensitive to DEPC and dye-sensitized inactivations. We conclude that His163 plays an important role in the catalytic function of agmatinase, but it is not directly involved in substrate binding.
Assuntos
Escherichia coli/enzimologia , Histidina/metabolismo , Ureo-Hidrolases/metabolismo , Catálise , Dietil Pirocarbonato/farmacologia , Inibidores Enzimáticos/farmacologia , Escherichia coli/genética , Cinética , Mutagênese Sítio-Dirigida , Rosa Bengala/metabolismo , Especificidade por Substrato , Ureo-Hidrolases/antagonistas & inibidores , Ureo-Hidrolases/genéticaRESUMO
Purified Escherichia coli agmatinase (EC 3.5.3.11) expressed the same activity in the absence or presence of added Mn2+ (0-5mM). However, it was strongly inhibited by Co2+, Ni2+, and Zn2+ and almost half inactivated by EDTA. Partial inactivation by EDTA yielded enzyme species containing 0.85 +/- 0.1 Mn2+/subunit, and it was accompanied by a decrease in intensity of fluorescence emission and a red shift from the emission maximum of 340 nm to 346 nm, indicating the movement of tryptophane residues to a more polar environment. The activity and fluorescence properties of fully activated agmatinase were restored by incubation of dialysed species with Mn2+. Manganese-free species, obtained by treatment with EDTA and guanidinium chloride (3 M), were active only in the presence of added Mn2+. Results obtained, which represent the first demonstration of the essentiality of Mn2+ for agmatinase activity, are discussed in connection with a possible binuclear metal center in the enzyme.
Assuntos
Escherichia coli/enzimologia , Manganês/metabolismo , Ureo-Hidrolases/metabolismo , Catálise , Proteínas Recombinantes/metabolismo , Espectrometria de FluorescênciaRESUMO
Full activation of human liver arginase (EC 3.5.3.1), by incubation with 5 mM Mn2+ for 10 min at 60 degrees C, resulted in increased Vmax and a higher sensitivity of the enzyme to borate inhibition, with no change in the K(m) for arginine. Borate behaved as an S-hyperbolic I-hyperbolic non-competitive inhibitor and had no effect on the interaction of the enzyme with the competitive inhibitors L-ornithine (Ki = 2 +/- 0.5 mM), L-lysine (Ki = 2.5 +/- 0.4 mM), and guanidinium chloride (Ki = 100 +/- 10 mM). The pH dependence of the inhibition was consistent with tetrahedral B(OH)4- being the inhibitor, rather than trigonal B(OH)3. We suggest that arginase activity is associated with a tightly bound Mn2+ whose catalytic action may be stimulated by addition of a more loosely bound Mn2+, to generate a fully activated enzyme form. The Mn2+ dependence and partial character of borate inhibition are explained by assuming that borate binds in close proximity to the loosely bound Mn2+ and interferes with its stimulatory action. Although borate protects against inactivation of the enzyme by diethyl pyrocarbonate (DEPC), the DEPC-sensitive residue is not considered as a ligand for borate binding, since chemically modified species, which retain about 10% of enzymatic activity, were also sensitive to the inhibitor.
Assuntos
Arginase/antagonistas & inibidores , Boratos/farmacologia , Inibidores Enzimáticos/farmacologia , Fígado/enzimologia , Manganês/metabolismo , Catálise , Humanos , Técnicas In VitroRESUMO
El objetivo de la presente investigación fue diagnosticar clínica y radiográficamente la presencia de caries dental, en una muestra seleccionada de adultos jóvenes, alumnos que ingresaron a 1er. año a la Facultad de Odontología. Proponer para las lesiones no cavitadas de esmalte, como tratamiento dental operatorio único terapias farmacológicas quimiopreventivas no invasivas, su aplicación durante tres años consecutivos y monitorear su control clínico a cinco años plazo. El control epidemiológico mediante el indice COP-D, realizado durante 5 años consecutivos, demostró que el promedio de caries clínica por alumno fue de 3.15 (2.9), y subió a un x 5.46 (3.7) caries con el examen radiográfico de aleta de mordida. El porcentaje de lesiones de caries no cavitadas (niveles 1 y 2), factibles de remineralizar, constituyeron el 62.4 por ciento, en relación al total de caries diagnosticadas
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Cárie Dentária , Estudantes de Odontologia , Distribuição por Idade , Análise de Variância , Chile , Cárie Dentária , Esmalte Dentário , Dentina , Índice CPO , Epidemiologia Descritiva , Fibras Ópticas/métodos , Programas Nacionais de Saúde , Odontologia Preventiva , Radiografia Dentária/métodos , Cárie Radicular , Interpretação Estatística de Dados , Transiluminação/métodosRESUMO
AIDS: It is no secret to the Venezuelan authorities that hundreds of citizens living with HIV/AIDS left the country (mainly to Canada and the United States) in search of treatment to prolong their lives. People who received treatment got better but were forced to stay in the country in order to continue the treatment. People who left in the advanced stages of AIDS returned in coffins. To assist people living with HIV/AIDS (PWAs) in Venezuela, organizations such as Citizen Action Against AIDS and United Against AIDS International have helped to bring thousands of dollars in medication to the country. They also provide emotional support to PWAs.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Infecções por HIV/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Fármacos Anti-HIV/economia , Fármacos Anti-HIV/uso terapêutico , Canadá , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Organizações , Apoio Social , Estados Unidos , Venezuela/epidemiologia , Venezuela/etnologiaRESUMO
Considerando que cada dia se utilizan más técnicas para evaluar "riesgo de caries", se utilizaron a través de 2 métodos microbiológicos: cuantitativo y semi-cuantitativo el recuento de colonias (UFC) de S. mutans/ml saliva, en 112 adultos jóvenes (68 mujeres y 44 hombres) estudiantes de Odontología, U. de Chile 1994, cuyo promedio de edad era 18.9 años. El porcentaje de estudiantes considerados como de alto riesgo (= a 1 x 10 elevado a 5 a 1 x 10 elevado a 6) correspondió al 31.2 porciento. En cuanto al número de caries diagnosticadas, tanto clínicas como radiográficas, en los grupos clasificados como de mayor o menor riesgo carioso, los resultados no mostraron una relación directa con el promedio de S muutans
Assuntos
Humanos , Masculino , Feminino , Adulto , Adolescente , Cárie Dentária , Streptococcus mutans/isolamento & purificação , Biotipologia , Contagem de Colônia Microbiana , Cárie Dentária/microbiologia , Sorotipagem , Técnicas BacteriológicasRESUMO
El análisi epidemiológico realizado, índice COP-D, en estudiantes de 1er año de odontología 1993. Universidad de Chile muestra las diferencias observadas al diagnosticar caries, y compararlas con un estudio radiográfico (técnica de aleta de mordida). Los valores promedios de caries clínica en 97 alumnos corresponden a 2,64 (2,7), de un COP-D 8,66 (3,8). Al examinar a 62 de ellos mediante la técnica de aleta de mordida, los valores por caries ascendieron a un promedio de 6,1 (3,3) de un COP-D 11,05 (3,3), valor que connstituye el 55 por ciento del COP-D total. De acuerdo a la clasificación realizada la presencia de lesiones de caries muy incipientes e incipientes constituyen un valor equivalente al 63,5 por ciento del total de las caries. El promedio de edad del grupo era de 18,7 años, constituida por un 54,6 por ciento de hombres y 45,3 por ciento de mujeres
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Cárie Dentária , Radiografia Interproximal/estatística & dados numéricos , Dente Pré-Molar , Diagnóstico Clínico , Cárie Dentária/classificação , Cárie Dentária/diagnóstico , Estudantes de Odontologia/estatística & dados numéricos , Dente Molar , Radiografia Dentária , Restauração Dentária Permanente/estatística & dados numéricosRESUMO
As determined by atomic absorption, fully activated human liver arginase contained 1.1 +/- 0.1 Mn2+/subunit. Upon dissociation to inactive subunits (< 0.01 Mn2+/subunit), there was decreased intensity and a red shift in the tryptophan fluorescence emission spectra of the enzyme, and the resulting species were markedly sensitive to thermal and proteolytic inactivation by trypsin. Arginine and lysine specifically protected the subunits from heat inactivation. Subunit activation by Mn2+ followed hyperbolic kinetics (Kd = 0.08 +/- 0.01 microM). In addition to Mn2+, Ni2+ and Co2+ converted inactive subunits into active monomers, and favoured their association to the oligomeric state of the enzyme (M(r) = 120,000 +/- 2000). The replacement of Mn2+ by Ni2+ or Co2+ resulted in significant changes in Vmax without any change in the Km values for the substrates (arginine or canavanine) or the Ki value for lysine inhibition. The results support our previous suggestion (Carvajal et al., 1994) that Mn2+ is not essential for substrate binding to arginase, and substantiates the conclusion that species differences may exist in the interaction of arginase with metal ions.
Assuntos
Arginase/metabolismo , Isoenzimas/metabolismo , Fígado/enzimologia , Metais/metabolismo , Arginase/antagonistas & inibidores , Humanos , Isoenzimas/antagonistas & inibidores , Cinética , Manganês/metabolismo , Especificidade da Espécie , Espectrometria de Fluorescência , TripsinaRESUMO
40 patients with advanced non-small cell lung cancer not previously treated were included in a study at phase II with vinorelbine 20 mg/Sq.m days 1 and 8, etoposide 60 mg/sq.m days 1-3 and cisplatin 75 mg/sq.m day 1 each 28 days for 6 cycles. There were 31 men and 9 women, being the average age of 54 years, with "performance Status" grade 0-2. All of them could be evaluated for toxicity and 31 for responsiveness. 10 patients were in stage IIIb and 21 at stage IV. 42% of objective responses were obtained and an overall survival of 9 months, which justifies further studies.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Adulto , Idoso , Antineoplásicos Fitogênicos/administração & dosagem , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Cisplatino/administração & dosagem , Etoposídeo/administração & dosagem , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , VinorelbinaRESUMO
40 patients with advanced non-small cell lung cancer not previously treated were included in a study at phase II with vinorelbine 20 mg/Sq.m days 1 and 8, etoposide 60 mg/sq.m days 1-3 and cisplatin 75 mg/sq.m day 1 each 28 days for 6 cycles. There were 31 men and 9 women, being the average age of 54 years, with [quot ]performance Status[quot ] grade 0-2. All of them could be evaluated for toxicity and 31 for responsiveness. 10 patients were in stage IIIb and 21 at stage IV. 42
of objective responses were obtained and an overall survival of 9 months, which justifies further studies.
RESUMO
El proceso de enfermería como herramienta de trabajo ha existido en los planes curriculares desde la década del 50, experimentando un continuo progreso en su aplicación. Mediante encuesta autoadministrada y anónima, se obtuvo información que permitió determinar el conocimiento sobre las etapas del proceso de enfermería, la aplicación y dificultades en la práctica profesional. Finalmente se presentan comentarios, conclusiones y recomendaciones con el fin de mejorar la aplicación del proceso de enfermería en nuestro medio.
Assuntos
Processo de Enfermagem , Prática ProfissionalRESUMO
From March 1986 to January 1993, we performed percutaneous balloon mitral commissurotomy (PBMC) in ninety-one patients with rheumatic mitral stenosis, two of them during pregnancy. The gestational age at the time of valvotomy was thirty and twenty-seven weeks respectively. Balloon Inoue technique in both cases resulted in improvement in mitral valve area (0.8 vs 1.6 and 0.7 vs 1.9 cm2) and in mean mitral gradient (19 vs 4 and 12 vs 0 mm Hg) immediately after dilation, without residual atrial septal defect or mitral insufficiency. There were no complications. The estimated radiation exposure to the fetus was of 6.4 minutes of fluoroscopy and 6 seconds of angiography. To limit of X-ray irradiation, we used color Doppler echocardiography during dilatation in both cases. The subsequent course of gestation was uncomplicated and normal babies were delivered in both cases. Fetus protection against ionising radiation was assured by lead mantles. In the follow-up the mitral valve area was 1.7 and 2.1 cm2, 15 and 4 months later respectively. PBMC can be performed safely during pregnancy and is effective in increasing the valvular area and relieving symptoms. It offers an excellent alternative for the pregnant patients, with severe mitral stenosis. The risk to the fetus appears lower than previous reports of surgical commissurotomy performed during pregnancy.