Key result
Percutaneous transvenous mitral commissurotomy significantly increased mean mitral valve area from 0.98 to 1.69 in patients with severe mitral stenosis.
Why the study?
Percutaneous Transvenous Mitral Commissurotomy is recommended for symptomatic severe mitral stenosis, but data on clinical profile and in-hospital outcomes in this setting were needed.
Cross-Sectional (n=104)
No
Absolute Event Rate: 1.69% vs 0.98%
p-value: p=<0.001
PTMC yields favorable in-hospital outcomes for mitral stenosis, especially in patients with Wilkin's score ≤8, with post-procedural MR generally well tolerated.
Supports using Wilkin's score ≤8 to select candidates for percutaneous mitral commissurotomy.
Introduction: Rheumatic heart disease (RHD), is a common cause of mitral stenosis (MS) in developing nations. As per current recommendation, Percutaneous Transvenous Mitral Commissurotomy (PTMC) is advised as a Class IA (I-Class Of Recommendation, COR; A-Level Of Evidence, LOE) indication in patients with symptomatic severe mitral stenosis. We aim to examine the clinical profile and in-hospital results of PTMC for mitral stenosis. Methods: A cross-sectional retrospective study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center from April 2020 to May 2022. A structured questionnaire was used to collect the data and ethical approval for conducting the study was taken from the Institutional Review Committee (IRC) of Institute of Medicine (IOM). The data was collected in Microsoft Excel (Ver. 2013). For statistical analysis, SPSS 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Association was measured using a parametric and non-parametric test (depending upon the distribution of data) and p value < 0.05 was considered significant. Results: after the procedure and it was statistically significant (p=<0.001). The post PTMC MVA varied with PTMC Wilkin's score with less than or equal to 8 having favorable outcomes. Conclusion: Successful PTMC is highly influenced by the patients' increasing age, valve morphology (calcification, thickness, mobility), Left atrial dimensions, Pre PTMC mitral valve area, Degree of Baseline mitral regurgitation. Post procedure development of MR is usually well tolerated but rarely be severe enough requiring surgical valve replacement.
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Yadav et al. (2022) conducted a cross-sectional in Mitral stenosis (n=104). Percutaneous Transvenous Mitral Commissurotomy (PTMC) vs. Pre-procedure baseline was evaluated on Mitral valve area (p=<0.001). Percutaneous transvenous mitral commissurotomy significantly increased mean mitral valve area from 0.98 to 1.69 in patients with severe mitral stenosis.
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