Author + information
- Md.Toufiqur Rahman and
- Md Afzalur Rahman
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 immediate and in-hospital results of Redo Percutaneous Transvenous Mitral Commissurotomy (PTMC) in patients with restenosis with previous PTMC.
The study group included 1320 consecutive patients who underwent PTMC at our national institute of cardiovascular diseases (NICVD), and Al -Helal Heart Institute, Euro-Bangla Heart Hospital, between May 2003 and December 2014. Safety, efficacy and in-hospital results of percutaneous transvenous mitral commissurotomy were analyzed in 1200 patients underwent PTMC without previous PTMC (group 1) and compared with 120 those of with previous PTMC (group 2).
Baseline demographic and clinical characteristics were similar in the 1200 patients without previous PTMC (group-1) and the 120 patients with previous PTMC (group-2) during the procedure. In the whole study group mitral valve area (MVA) was 0.84 ± 0.08 cm2 prior to PTMC, and increased to 1.75 ± 0.08 cm2 after the procedure (p = 0.0001). The mean increase in MVA was 0.79 ± 0.32 cm2 in the group-1 and 0.78 ± 0.42 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 haematoma at puncture site in 15 patients in group-1 vs 08 patients in group-2 and the development of pericardial temponade and urgent pericardiocentesis in 3 patients in group-1 vs 1 patients in group-2, were similar in both groups.
PTMC in selected patients with mitral restenosis after previous PTMC can be performed safely and with similar immediate efficacy and in-hospital outcome in patients with Mitral stenosis.