Procedural Success and Immediate Results of Percuteneous Trans Mitral Commissurotomy: An Experience from a Tertiary Care Hospital in Northern Division of Bangladesh

Abstract

Background: One of the ultimate grave consequences of rheumatic heart disease is mitral stenosis. Percutaneous trans-mitral commissurotomy (PTMC) has been practiced with good results in the world since Inoue introduced it in 1982. But in Bangladesh we have very few research-oriented data regarding the effectiveness and patient compliance of this procedure. Aim of the study: The aim of this study was to audit the procedural success, in-hospital outcome in patients undergoing percutaneous trans-mitral commissurotomy (PTMC). Methods: This observational cross-sectional study was conducted in northern division of Bangladesh with the collaboration of the Department of Cardiology, Rangpur Medical College Hospital, Rangpur & Zia Heart Foundation, Dinajpur during the period from February 2018 to November 2019. In total 45 patients who fulfill the inclusion and exclusion criteria for PTMC was enrolled in this study as the study people. Among them the procedural success & immediate results were assessed. Proper written consents were taken from all the participants before starting data collection. A pre-designed questionnaire was used in patent data collection. All data were processed, analyzed and disseminated by MS Office and SPSS version as per need. Result: In our study in analyzing the comparative Echo Doppler data of pre & post PTMC among the participants in both mean (±SD) MVA (cm2) and mean (±SD) MVPG (mmHg) we found extremely statistically significant correlation between pre and post PTMC stages where the P values were less than 0.0001. Besides these, in analyzing the pre & post PTMC hemodynamic and procedural data of participants we observed, against LA Pressure (mmHg) (Mean ± SD), RV Pressure (mmHg) (Mean ± SD), LVEDP (mmHg) (Mean ± SD) and Transmitral PG (mmHg) (Mean ± SD) there were extremely significant correlation between pre and post PTMC stages. In all the parameters the p values were less than 0.0001. Conclusion: We conclude that, percutaneous trans-mitral commissurotomy (PTMC) is a safe procedure in experienced hand with good success rate and optimal results even in patients with special problems like pregnancy, previous CVA and redo cases.