Percutaneous transvenous mitral commissurotomy.

Two hundred patients underwent Percutaneous transvenous mitral commissurotomy (PTMC) from January 2003 to July 2004. Seventy four percent of the patients were female. Age ranged from 10 years old to 61 years and mean age was 29 years. Twenty three percent of the patients were under 21 years of age. Atrial fibrillation was present in 32.0% of the cases. Mean mitral valve area increased from 0.90cm2 (+/- 0.14) to 1.82cm2 (+/- 0.21) (p = 0.018). Left atrial mean pressure decreased from 21 mmHg mean to 7 mmHg. Subjective improvement was reported in 98.0% of the patients immediately after the procedure. There was no mortality during the hospital stay or within the first month of the procedure. Significant mitral regurgitation of grade 3 was noted in 5 patients. Two developed severe mitral regurgitation. The complications were negligible. One had systemic embolisation during the procedure which recovered over a period of time. One developed deep vein thrombosis which recovered after treatment.

Use of PercuSurge in primary angioplasty.

Thrombus load and its subsequent distal embolization causing slow flow makes primary angioplasty a challenging task. Although data is scanty, these complications may be potentially mitigated by use of distal protection devices. We report 6 cases of PercuSurge distal protection device-assisted primary angioplasty. All lesions were stented with patients achieving brisk TIMI 3 flow; none of the patients had in-hospital major adverse cardiac events. The strategy of PercuSurge Guardwire-assisted primary angioplasty seems encouraging in improving successful outcome in this subset of patients.