ABSTRACT
Tricuspid stenosis [TS] is rare disorder; it is associated with rheumatic mitral stenosis [MS] in about 3% of the patients. When both exist together; combined percutaneous balloon valvuloplasty can be a good choice in suitable patients. The results of five patients with rheumatic MS and TS treated with concurrent balloon valvuloplasty were presented in this report. These five patients were females with a mean age of 30 yrs and they are the first cases conducted in Sudan. The mitral valve area [MVA] increased from 0.82 to 2.1cm while the tricuspid valve area [TVA] increased from 1.1 to 2.6cm, the mean transvalvular gradient dropped from 18 to 6mmHg across the mitral valve [MV] and from 10 to 3mmHg across the tricuspid valve [TV]. The right ventricular [RV] pressure dropped from 65 to 35mmHg while the jet area of the secondary tricuspid regurgitation [TR] hasn't increased as assessed by Color Doppler. All the patients showed a remarkable clinical improvement. This study demonstrates that balloon valvuloplasty of the two valves, concurrently performed, is a good palliative treatment and may save or delay the need for surgery
ABSTRACT
Balloon valvuloplasty for stenosed mitral and pulmonary valves has been practiced with good results for the last two years in Ahmed Gasim Cardiac Centre, Khartoum Sudan. The aim of this study is to audit percutaneous trans-mitral balloon commissurotomy [PTMC] in our current set up. One hundred and eight patients underwent percutaneous transvenous mitral commissurotomy [PTMC] from April- 2004 to December-2005 in Ahmed Gasim cardiac center. 67% of the patients were females. Age range was from 13 years to 65 years and the mean age was 27 years. 27% were under 21 years of age and 12% had special problems. The procedural success was achieved in 94.5% patients, in two patients we failed to dilate a tough septum, in other two the balloon got stuck to the septum and failed to cross the MV, while two patients had successful emergency MVR [due to inadvertent puncture of the RA and cardiac tamponade]. There was no mortality related to the procedure, significant mitral regurgitation of> grade 2 didn't occur. No patient developed systemic embolization. Optimal results were achieved in 91.6% patients and in 92% of the patients with special problems. Hemodynamic data in the Cath. Lab showed left atrial mean [ +/- SD] pressure dropped from 32 [ +/- 3.2] mmHg to 12 [ +/- 2.4] mmHg. LA-LV gradient dropped from an average of 25 to 5 mmHg. Echocardiographic assessment showed mean [ +/- SD] mitral valve area increased from 0.86 [ +/- 0.19] cm[2] to 1.9 [ +/- 0.5] cm[2] [p<0.001] and PA pressure dropped from71 [ +/- 23] to 40 [ +/- 12] mmHg [p<0.01]. We conclude that PTMC is a safe procedure with good success rate and optimal results even in patients with special problems like redo and previous CVA