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June 1, 2017The Professional Medical Journal2 citationsOpen Access

Severe Mitral Stenosis; In-Hospital Outcomes of Percutaneous Transvenous Mitral Commissurotomy (Ptmc) in Patients

HBHaroon Aziz Khan BabarASAbubakr Ali SaadZBZahid Rafique Butt

Key Result

Percutaneous transvenous mitral commissurotomy significantly increased mitral valve area from 0.63 cm2 to 1.83 cm2 and achieved a 97.7% procedural success rate in severe mitral stenosis.

Study Design

Type

Cross-Sectional (n=90)

Multicenter

No

Structured PICO

Does percutaneous transvenous mitral commissurotomy (PTMC) improve mitral valve area and hemodynamics in patients with severe mitral stenosis?

P
Population
90 patients (mean age 28 years, 65.5% female) with severe mitral stenosis and valve area <1.0 cm2, evaluated for immediate hemodynamic outcomes 24 hours after percutaneous transvenous mitral commissurotomy.
E
Exposure
Percutaneous transvenous mitral commissurotomy (PTMC) using self-positioning Inoue balloon under local anesthesia via right femoral venous approach.
O
Outcome
Procedural success (increase in mitral valve area more than 50% of the baseline area without the development of moderate to severe MR) evaluated after 24 hours.surrogate

PTMC is a highly successful and safe procedure for patients with severe mitral stenosis, significantly improving mitral valve area and hemodynamics.

Main Result

Absolute Event Rate: 1.83% vs 0.63%

p-value: p=<0.001

Limitations

  • Single-center study
  • Small sample size
  • Lack of long-term follow-up

Abstract

Objectives: To evaluate the immediate outcomes of PTMC in patients with severemitral valve stenosis. Study Design: Cross-sectional study. Setting: Ninety (90) subjects whounderwent PTMC in Cardiac Catheterization Department of CPE Institute of Cardiology. Period:June 2008 to June 2011. Methods: Patients with severe MS having mitral valve (MV) area <1.0cm2 and having morphology suitable for PTMC in the absence of regurgitation and left atrial clotwere included in this study. An increase in mitral valve area more than 50% of the baseline areawithout the development of moderate to severe MR was considered as the procedural success.Data were analyzed using SPSS V19. Pre and post procedural outcomes were measured usingpaired sample t-test. Results: There were a total number of ninety (90) patients in this study.Mean age of subjects was 28.08+9.61 years. There were more females 59 (65.5%) as comparedto only 31 (34.5%) males. There was significant increase in mitral valve area, 1.83+0.36 cm2post-PTMC versus 0.63+0.17 cm2 pre-PTMC (p-value <0.001). There was significant decreasein Peak pressure gradient (PPG) from 28.31+6.01 mmHg to 12.85+3.20 mmHg after PTMC(p-value <0.001). There were also significant reductions in mean pressure gradient andpulmonary artery systolic pressures after PTMC with p-value <0.001 and <0.001 respectively.PTMC was successful in 87 (97.7%) patients and it failed in only 3 (3.3%) patients. Conclusion:PTMC is an excellent treatment option regarding optimal outcomes and success rate in patientsof severe mitral stenosis especially when performed by experienced interventionists.

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Cite This Study

Babar et al. (2017) conducted a cross-sectional in Severe mitral valve stenosis (n=90). Percutaneous Transvenous Mitral Commissurotomy (PTMC) vs. Pre-procedure baseline was evaluated on Mitral valve area (cm2) (p=<0.001). Percutaneous transvenous mitral commissurotomy significantly increased mitral valve area from 0.63 cm2 to 1.83 cm2 and achieved a 97.7% procedural success rate in severe mitral stenosis.

synapsesocial.com/papers/6a208aa87eef7217eecc4047https://doi.org/10.17957/tpmj/17.3697
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