Immediate Outcome and Predictors of Percutaneous Mitral Balloon Commissurotomy: A 5 Years Experience in Cardiac Center Ethiopia

Percutaneous mitral balloon commissurotomy (PMBC) is the treatment of choice for rheumatic mitral stenosis with favorable anatomy and prevents complications inherent to a surgical procedure, while maintaining effectiveness. In view of this, we examined the immediate outcome and its predictors of patients undergoing PMBC in our Cardiac Center and availed evidence based information for future use of the treatment in Ethiopia. A retrospective data analysis of 330 patients with symptomatic severe mitral stenosis treated with PMBC using Inoue balloon in the cardiac center Ethiopia from 2014 to 2018 were assessed for their clinical outcome for those who presented for the first time in our cardiac center, Addis Ababa. Demographic, clinical, echocardiographic and hemodynamic data of all patients with symptomatic severe mitral stenosis were collected and analyzed. Of the 330 PMBC performed during the 5 years in the center, the majority had successful procedure (97.88%) and optimal result (92.42%). Twenty four (7.2%) had complications of which 7 (2.1%) had failed procedure and 9 (2.7%) marked mitral regurgitation. Atrial fibrillation was observed in 67 (20.3%). The mean mitral valve score (MVS) was 7.3± 1.35 ranged from 4 to 13. A significant association of immediate outcome was observed with atrial fibrillation (AOR=4.41; 95% CI=1.51 to 12.89) and high mitral valve total Wilkins score (AOR=0.25; 95% CI 0.09 to 0.70). The major predictors identified for poor outcome are atrial fibrillation and MVS. Percutaneous mitral balloon commissurotomy is a safe procedure with excellent immediate results signifying that it is a treatment of choice for heterogeneous group of patients with rheumatic mitral stenosis.