Percutaneous transvenous mitral commissurotomy; outcome of in patients of mitral stenosis

ABSTRACT

To compare the clinical, echocardiographic and angiographic variables after PTMC in patients of mitral stenosis having echo score < 8 and >/= 8. Cardiology ward and echocardiography department of the Punjab Institute of Cardiology, Lahore. The study was conducted from 15[th] of January 2006 till 30[th] of July 2006. It was a comparative study. Two hundred consecutive patients of mitral stenosis undergoing PTMC were studied. Patients were divided in to two groups. Group I consisted of patient having echo score <8, while Group II contained patients having echo score >=8. The immediate clinical follow-up of 200 patients who underwent PTMC procedure was studied. Patients were divided into 2 groups, Echo-Sc <8 [n=136] and Echo-Sc >/= 8 [n=64]. PTMC resulted in an increase in mitral valve area from 1.0 +/- 0.3 to 2.0 +/- 0.6 cm[2] in patients with Echo-Sc<8 and from 0.8 +/- 0.3 to 1.6 +/- 0.6 cm[2] in patients with Echo-Sc >/= 8 [P<0.0001]. Procedural success was 83.5% for the overall group, with patients with Echo-Sc <8 having a higher procedural success [93.4% versus 62.5%; P<0.0001]. Thirty three [16.5%] patients had unsuccessful procedures. There was 1 [0.5%] in-hospital death. Severe post- PTMC MR [>/= 3 grade] occurred in 19 [9.4%] patients, with grade III in 12 [6%] and grade IV in 7 [3.5%]. Emergent MVR was required in 3 [1.5%] of 200 patients. Pericardial tamponade occurred in 2 [1%] patients. Thromboembolic events [stroke] occurred in 2 [1%] patients in the overall population. Finally 1 [0.5%] patient developed complete atrioventricular block. Patients with echo score less than 8 have a favourable outcome in terms of procedural success and post procedure complications as compared to patients with echo score >/= 8