Abstract
Objective: The objective of our study was to assess the reduction in severe pulmonary hypertension after PTMC in patients of severe mitral stenosis. Methodology: One hundred twenty-four patients of severe mitral stenosis with severely elevated pulmonary pressures more than 50 mmHg between 15 to 60 years of age of either gender undergoing elective PTMC at Chaudry Pervaiz Elahi Institute of Cardiology, Multan were included in this study. Post PTMC pulmonary pressures were noted 24 hours after PTMC. Results: Mean age of the patients was 35.45 ± 10.38 years. Diabetes mellitus was found to be present in 39/124 (31.5%), hypertension in 40/124 (32.3%) while no comorbidities were found in 62/124 (50%). Mean baseline pulmonary artery systolic pressure was found to be 72.61 ± 8.11 mmHg while mean pulmonary artery systolic pressure after PTMC was found to be 45.09 ± 6.06 mmHg. The pulmonary artery systolic pressure fallen from baseline by 37.92 ± 4.19 mmHg after the commissurotomy. Transvenous mitral commissurotomy was found to be effective with a minimum 1/3rd reduction in 119/124 (96%) while it was ineffective in 5/124 (4%) of the patients. Conclusion: Therefore, we conclude that balloon valvotomy is a useful procedure which results in a significant reduction in mean pulmonary artery systolic pressure irrespective of age, gender or comorbidities.
Highlights
Mitral stenosis (MS) in 99% of cases is due to rheumatic involvement of this apparatus resulting in obstruction in flow from left atrium to left ventricle.Patients of mitral valve involvement typically appear in combination of stenosis and regurgitation in most cases
The pulmonary artery systolic pressure fallen from baseline by 37.92 ± 4.19 mmHg after the commissurotomy
Conclusion: we conclude that balloon valvotomy is a useful procedure which results in a significant reduction in mean pulmonary artery systolic pressure irrespective of age, gender or comorbidities
Summary
Mitral stenosis (MS) in 99% of cases is due to rheumatic involvement of this apparatus resulting in obstruction in flow from left atrium to left ventricle.Patients of mitral valve involvement typically appear in combination of stenosis and regurgitation in most cases. The reported incidence of LA clot formation in sinus rhythm (SR) is 6.6%, assessed on trans-esophageal echocardiography and having no clot on trans-thoracic echocardiography.[3] These events are believed to be caused primarily by embolisation of left atrial thrombi, when a thrombus is dislodged during the procedure. It wouldn’t be wrong to phrase left atrial clot is an absolute contraindication for PTMC
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