Percutaneous transvenous mitral commissurotomy for rheumatic mitral stenosis with impaired left ventricular function: an echocardiographic follow-up study (original) (raw)
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BMC Cardiovascular Disorders, 2021
Background Rheumatic heart disease (RHD) is still a concerning issue in developing countries. Among delayed RHD presentations, rheumatic mitral valve stenosis (MS) remains a prevalent finding. Percutaneous transvenous mitral commissurotomy (PTMC) is the intervention of choice for severe mitral stenosis (MS). We aimed to assess the mid-term outcome of PTMC in patients with immediate success. Methods In this retrospective cohort study, out of 220 patients who had undergone successful PTMC between 2006 and 2018, the clinical course of 186 patients could be successfully followed. Cardiac-related death, undergoing a second PTMC or mitral valve replacement (MVR) were considered adverse cardiac events for the purpose of this study. In order to find significant factors related to adverse cardiac outcomes, peri-procedural data for the studied patients were collected.The patients were also contacted to find out their current clinical status and whether they had continued secondary antibiotic ...
Immediate impact of percutaneous transvenous mitral commissurotomy on right ventricular function
Nepalese Heart Journal
Background and Aims: Abnormal Right Ventricular (RV) function affects the long term outcome and clinical symptoms in patients with mitral stenosis (MS). This study evaluates the immediate effect of Percutaneous Transmitral Commisurotomy (PTMC) on RV function.Methods: An observational, cross sectional study was done on 50 patients with rheumatic MS who underwent PTMC at Shahid Gangalal National Heart Center from Dec 2015 –Dec 2016. All underwent clinical evaluation and echocardiogram before and immediately after PTMC.Results: There was female preponderance with 66% being female. The mean age was 37.26 ± 10.63 years. There was immediate increase in the mitral valve area (MVA) from 0.87 ± 0.12cm2 to 1.54 ± 0.27cm2(p< 0.001). There was significant decrease in mean mitral diastolic gradient from 16.4 ± 8.8mmHg to 5 ± 1.5mmHg (p< 0.001), in the pulmonary artery systolic pressure 53.6 ± 21.83mmHg to 39.5 ± 14.67mmHg (p< 0.001), in the RV Tei index from 0.56 ± 0.08 to 0.40 ± 0.08 (...
University Heart Journal, 2015
Mitral stenosis (MS) is a disabling and eventually lethal disease. Untreated progressive disease can lead to significant symptoms and serious complications. The great majority of cases in adults are due to rheumatic heart disease, with symptoms usually appearing 16 to 40 years after the episode of acute rheumatic fever. According to the annual report by the World Heart Federation, an estimated 12 million people are currently affected by rheumatic fever and rheumatic heart disease worldwide, prevalence of rheumatic heart disease, reporting 0.14/1000 in Japan (Kawakita 1986), 1.86/1000 in China 20 0.5/1000 in Korea 18 , 4.54/1000 in India 1 , and 1.3/1000 in Bangladesh 2. Among them mitral valve is affected in 75% cases. Abnormalities of right ventricular function (RVF) play an important role in the development of clinical symptoms and the overall prognosis of the patients with mitral valve stenosis (MS) 4,14. RVF may be affected by the Rheumatic process directly (Borer, Hochreiter & Rosen 1991) or through hemodynamic changes due to pulmonary vascular
Heart, vessels and transplantation, 2022
Objective: Patients with rheumatic mitral stenosis, despite having normal left ventricular ejection fraction (LV EF), have ventricular dysfunction in the form of impaired longitudinal excursion. Tissue Doppler velocity is a useful indicator for assessment of long-axis ventricular shortening and lengthening. The aim of our study was to evaluate the effect of percutaneous balloon mitral valvuloplasty (PBMV) on LV function in rheumatic MS and to study echocardiographic parameters with M-Mode and Tissue Doppler Imaging pre PBMV, post PBMV and on follow-up to determine predictors of LV function. Methods: We analysed 52 patients with severe mitral stenosis with normal LV EF, who underwent PBMV at our institute. Baseline parameters of LV function were compared with immediate post PBMV and at three months follow up. Results: The mean age of the patients was 33.73 (10.87) years with female preponderance. The mean mitral valve area before PBMV was 0.92 (0.13) cm 2 which increased to 1.65 (0.21) cm 2 after PBMV and at 3 month it was 1.61 (0.23) cm 2 (p<0.001). LVEF before PBMV by modified Simpson's method was 55.45 (8.44)% and after PBMV, it was 55.58 (3.46)% and at 3 month it was 56.62 (2.46)% (p>0.05). Mitral valve E' was 8.71 (1.54) cm/s which increased to 10.13 (1.68) cm/s post PBMV and at 3 month it was 10.83 (1.34) cm/s (p<0.001).. Mitral annular systolic velocity (MASV), before PBMV was 7.90 (0.96) cm/s which increased to 9.31 (1.68) cm/s after PBMV and at 3 month it was 10.13 (0.96) cm/s (p<0.001). Myocardial performance index (MPI) before PBMV was 0.54 (0.48) which decreased post PBMV to 0.47 (0.06) and at 3 month it was 0.38 (0.04) (p=0.01). Pre PBMV MPI value <0.48 predicted improvement in LV function (sensitivity: 81%, specificity: 58.1%). Conclusion: Thus, PBMV leads to improvement in LV function in patients with severe MS with normal LV EF.
Journal of Ayub Medical College, 2020
Mitral stenosis (MS) is a prevalent disease in the developing world. It is a preventable disease associated with considerably high morbidity and mortality rates. Myocarditis secondary to rheumatic MS can cause left ventricular (LV) dysfunction. In majority of the case this LV dysfunction is subclinical. Recent development in imaging techniques like tissue Doppler imaging (TDI) and strain imaging enabled us to detect subclinical LV dysfunction. One such example is Global Longitudinal Strain (GLS), which is a reliable mean of assessing LV dysfunction in patients diagnosed with mitral stenosis. This study is design to determine the frequency of subclinical LV dysfunction in patients presenting with severe MS of rheumatic etiology in our institute. Objective of the study was to determine frequency of subclinical LV dysfunction by mean GLS in patients with isolated severe Rheumatic MS having normal LV Ejection fraction measured by 2D/M-mode echocardiography. It was an observational cross...
Japanese Circulation Journal, 1999
ercutaneous transvenous mitral commissurotomy (PTMC) has been established as a reasonable treatment of choice since its first introduction as a clinical application. 1 In the majority of mitral stenosis (MS) patients, PTMC provides good immediate improvements of both cardiac hemodynamics and clinical symptoms. 2-14 However, there are few published reports concerning the long-term outcome of mitral valve area (MVA), clinical events and the functional limit of daily activities. 15,16 Because most of the previous studies were retrospective, they provides limited information on post-procedural exacerbation. Moreover, few studies have been done in a single laboratory with a uniform technique. We report the long-term results after successful PTMC using the single-balloon technique, performed and then evaluated in the same institution. The annual follow-up was focused on the MVA and clinical events. Methods Study Patients From June 1987 to December 1990, 132 patients underwent PTMC in Mitsui Memorial Hospital. Achievement of either a MVA >1.5 cm 2 or a MVA of more than twice the pre-PTMC value was a requirement for procedural success. Another requirement was the absence of exacerbated mitral regurgitation (MR) of grade of 2+ or more by Sellers clas
Isolated left ventricular noncompaction in association with rheumatic mitral stenosis
International Journal of Cardiology, 2008
Fifty year old man with a known case of chronic rheumatic heart disease with atrial fibrillation was presented with severe mitral stenosis. He was incidentally detected to have noncompaction of left ventricle on echocardiography and Doppler examination. He underwent successful percutaneous trans-luminal mitral commissurotomy (PTMC) for severe mitral stenosis. This is the first reported case of isolated ventricular noncompaction (IVNC) associated with acquired chronic rheumatic mitral stenosis.
Cardiovascular Journal, 2012
Background: The aim of this study was to evaluate the immediate impact of Percutaneous Transvenous Mitral Commissurotomy (PTMC) on RV function in patients with mitral stenosis (MS).Methods: This study was conducted in the National Institute Cardiovascular Diseases, Dhaka for a period of one year starting from October 2008 to September 2009. A total of 50 consecutive patients (Case group) with mitral stenosis were selected after considering inclusion and exclusion criteria that subsequently undergone PTMC. The control group (n=50) consisted of age and sex matched healthy individual (having no ECG or echocardiographic evidence of structural or functional cardiovascular disease). Healthy control group was taken because there was no data about RV function in our population. Control group used to compare with baseline characteristics of case group.Results: Immediately after PTMC (24 to 48 hours) mitral valve area increased from 0.8± 0.1 to 2.0 ± 0.2 (p <0.001) and RV outflow tract fra...