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Rheumatic fever and rheumatic heart disease continue to be the major health problem in all developing countries including Bangladesh. Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2:1. Percutaneous balloon mitral commissurotomy is appealing because the mechanism of valve dilation closely parallels the mechanism of surgical mitral commissurotomy. We aimed to study the clinical, echocardiographic and hemodynamic profile of patients with symptomatic moderate to severe rheumatic mitral stenosis in our population who undergone percutaneous transvenous mitral commissurotomy (PTMC).
A prospective study was done in National Institute of Cardiovascular Diseases, Dhaka, Bangladesh and Al- Helal Heart Institute, Mirpur, Dhaka during the period of August 2003 to December 2014. Sixteen hundred and fifty (1650) patients with rheumatic mitral stenosis undergoing PTMC were evaluated clinically , by echocardiography and by catheter before the procedure.
Mean age of the study population was 28.43 ± 10.21 years, range of study population was 14-68 years. Most of the population are female (82%). 60% patients presented with pure MS, 65% presented with NYHA class 3-4 group. 84% patients presented with Wilkins Echo score ≤ 8. Mean mitral valve area was 0.81 ± 0.14 cm2 as measured by echocardiography. Mitral valve gradient was 27.46 ± 04.94 mm Hg before PTMC. Left atrial size was 37.25 ± 08.62 mm. Mean left atrial pressure as recorded by catheter before PTMC was 30.99 ± 08.37 mm Hg. Mean aortic pressure was 90 ± 05 mm Hg before the procedure.
Most of the patients were young, female, dysnoeic with NYHA class 3-4 and low Wilkins Echo score.