Percutaneous balloon mitral valvotomy significantly reduced left atrial appendage area (5.43 to 4.74 cm2, p<0.001) and increased emptying and filling velocities at 24 hours post-procedure.
Observational (n=19)
Does percutaneous balloon mitral valvotomy improve left atrial appendage area and contractile function in patients with severe rheumatic mitral stenosis?
Successful percutaneous balloon mitral valvotomy significantly reduces left atrial appendage size and improves its contractile function within 24 hours.
Absolute Event Rate: 4.74% vs 5.43%
p-value: p=<0.001
Abstract Introduction In properly selected patients, percutaneous balloon mitral valvotomy obtains excellent immediate and sustained hemodynamic improvement, comparable to the results of surgical procedures, including open or closed mitral commissurotomy and mitral prosthetic replacement. Left atrial appendage acts as a chamber to depressurize the left atrium. In due course of severe rheumatic mitral stenosis, the left atrial appendage becomes dilated and loses its contractile function. When the left atrium is depressurized, left atrial appendage should be able to regain its contractile function and reduces in size. Scarce research has been done on left atrial appendage pre and post percutaneous balloon mitral valvotomy. Objectives To compare left atrial appendage area by 2D 0.05 were taken as significant in all statistical comparisons. Results The mean 2-dimensional MVOA of 0.79±0.16 cm2 prior to PBMV increased to 1.87±0.25 cm2 post PBMV (p0.001). The mean MVGp of 21.6±6.82 mm Hg prior to PBMV reduced to 11.6± 2.73 mm Hg after successful PBMV (p0.001). The mean MVGm of 13±4.1 mm Hg prior to PBMV was reduced to 4.84±1.1 mm Hg after successful PBMV (p0.001). The mean LAA area at 450 was 5.43±0.78 cm2 which decreased to 4.74±0.62 cm2 after successful PBMV (p0.001). The mean LAA area at 900 was 5.43±0.78 cm2 which decreased to 4.74±0.62 cm2 after successful PBMV (p0.001). The mean LAA LEV increased from 21.71±4.01 cm/sec to 33.02±6.91 cm/sec following PBMV (p0.001). The mean LAA EFV improved from 30.89±8.67 cm/sec to 42.26±12.12 cm/sec following PBMV (p0.01). All the values obtained were analysed using paired t-Test and were statistically significant. Conclusion There is significant reduction of LAA area post successful PBMV signifying LAA can regain its size and morphology post PBMV. There is significant increase in LAA filling and emptying velocity post successful PBMV signifying regain of contractile function of LAA in patients with sinus rhythm.TEE assessment pre and post PBMVFor image description, please refer to the figure legend and surrounding text. Results and AnalysisFor image description, please refer to the figure legend and surrounding text.
Iliyas et al. (Sun,) conducted a observational in Severe rheumatic mitral stenosis (n=19). Percutaneous balloon mitral valvotomy vs. Pre-procedure baseline was evaluated on Left atrial appendage area at 45 degrees (cm2) (p=<0.001). Percutaneous balloon mitral valvotomy significantly reduced left atrial appendage area (5.43 to 4.74 cm2, p<0.001) and increased emptying and filling velocities at 24 hours post-procedure.