Author + information
Rheumatic fever and rheumatic heart disease continue to be the major health problem in all developing countries including Bangladesh. Percutaneous Transvenous mitral Commissurotomy (PTMC) is an established non-surgical modality for the treatment of severe rheumatic mitral valve stenosis. The purpose of this study was to evaluate our immediate and in-hospital results of Percutaneous Transvenous Mitral Commissurotomy(PTMC) in patients with restenosis with previous mitral surgery(CMC).
The study group included 990 consecutive patients who underwent PTMC between May 2003 and December 2012. Safety, efficacy and in-hospital results of percutaneous transvenous mitral commissurotomy were analyzed in 900 patients underwent PTMC without previous CMC (group 1) and compared with 90 those of with previous CMC (group 2).
Baseline demographic and clinical characteristics were similar in the 900 patients without previous CMC (group-1) and the 90 patients with previous CMC (group-2) during the procedure. In the whole study group mitral valve area (MVA) was 0.85 ± 0.09 cm2 prior to PTMC, and increased to 1.76 ± 0.07 cm2 after the procedure (p = 0.0001). The mean increase in MVA was 0.78 ± 0.31 cm2 in the group-1 and 0.79 ± 0.41 cm2 in the group-2 (NS). During the procedure or in-hospital after PTMC, embolic events were recorded in 3 patients in group-1 and 2 patients in group-2 (NS). The frequency of minor hematoma at puncture site in 15 patients in group-1 vs 13 patients in group-2 and the development of pericardial tamponade and urgent pericardiocentesis in 3 patients in group-1 vs 3 patients in group-2, were similar in both groups.
PTMC in selected patients with mitral restenosis after previous surgical commissurotomy (CMC)can be performed safely and with similar immediate efficacy and in-hospital outcome in patients with Mitral stenosis.