Clinical Hemodynamic and Echocardiography Data Analysis for Patients with Mitral Stenosis Before and After PTMC Procedure at Rajaie Cardiovascular Center Between 2015 and 2016

Abstract

Background: Mitral stenosis is a common and important type of valvular heart disease. This study was performed to determine and compare the hemodynamic, echocardiographic and clinical data before and after percutaneous transvenous mitral commissurotomy (PTMC). Methods: In this prospective cohort, the data for 171 consecutive patients with PTMC at a university referral heart hospital have been collected and analyzed from March 2015 till September 2016. Due to the missing data reported on the medical charts, 20 cases were further dismissed. Therefore, clinical study on hemodynamic monitoring and echocardiography have been observed and compared on the remaining 151 consecutive cases. In this study, demographic data, clinical symptoms and medication before the procedure and systolic pulmonary arterial pressure (SPAP), pulmonary capillary wedge pressure (PCWP), trans mitral valve gradient and mitral valve area (MVA) before and after PTMC have been measured. Results: The results showed that according to Wilcoxon test there was a significant increase in PCWP, significant decrease in mean gradient of mitral valve and significant reduction in SPAP after PTMC (P = 0.0001). In this study, post-procedure mitral regurgitation (MR) values after echocardiography and angiography have been compared and it was stated that about 90.4% (138 cases) are diagnosed with mild MR (no MR and mild MR) in angiography while 10.6% (16 cases) have trivial and mild MR in echocardiography (P < 0.0001). Conclusions: Totally it may be concluded that there is significant difference between the hemodynamic and echocardiographic data after PTMC. Echocardiography estimates the MR complications after PTMC to be higher than angiography.