Comparison of mitral valve area, pulmonary function and pulmonary artery hypertension in patients with chronic rheumatic mitral stenosis undergoing surgical closed mitral valvotomy (SCMV) versus percutaneous balloon mitral valvotomy (PBMV)

Background: Rheumatic valvular heart disease, commonly mitral stenosis, complicate 1% of pregnancies. Balloon mitral valvuloplasty (BMV) is an established treatment of rheumatic mitral stenosis. Aim of the study was to assess the safety and efficacy of Balloon mitral valvuloplasty in pregnant women with severe mitral stenosis. Materials and Methods: 66 patients who failed to respond to medical therapy undergoing BMV during pregnancy were analysed in this retrospective study. Mitral valve area (MVA), transmitral Mean valve gradient (MVG), and mitral regurgitation (MR), Pulmonary artery pressure (PAP) were assessed before and 24 hours after the procedure by transthoracic echocardiography. Patients were followed up to one month post BMV and neonates were monitored for the adverse effect of radiation. Results: Mitral valve area increased from 0.83 ± 0.13 cm2 to 1.38 ± 0.29 cm2 (P = 0.007). Mean gradient mitral valve gradient decreased from 15.5 ± 7.4 mmHg to 3.36 ± 2.36 mmHg (P = 0.001). Pulmonary artery pressure decreased from 65.24 ± 17.9 to 50.45 ± 15.33 (P = 0.012). No maternal death, intrauterine growth restriction was observed. Conclusion: Balloon mitral valvuloplasty has favourable immediate good outcomes for mothers and newborns.

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An analysis of percutaneous balloon mitral valvotomy: a tertiary care centre study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20202105 ◽

2020 ◽

Vol 7 (6) ◽

pp. 924

Author(s):

Prem Kumar Thota ◽

Rajesh Dake

Keyword(s):

Mitral Valve ◽

Mitral Stenosis ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Mitral Valve Area ◽

Percutaneous Balloon ◽

Number Of Patients ◽

Study Population ◽

Mitral Valvotomy ◽

Valve Area

Background: The prevalence of rheumatic heart disease (RHD) has markedly decreased in several countries but is still present in underdeveloped and developing countries, 33 million people around the world affected by RHD. Percutaneous balloon mitral valvotomy (PBMV) or valvotomy via femoral cut down using a balloon dilating catheter used in a small number of patients` as an alternative to surgical mitral commissurotomy.Methods: A retrospective, observational study included 37 patients who were diagnosed to have severe mitral stenosis between October 2017 and October 2019 were included in the study. Primary endpoint was considered as in-hospital mortality and secondary endpoint was considered as 6 months clinical outcomes. All patients were evaluated clinically by the same investigator who performed PBMV.Results: The mean age of the study population was 36.6±11.37 years. There was a female predominance 27 (72.97%) patients. Out of total patients; an optimal result was achieved in 33 (89.19%) patients, 1patient developed pericardial effusion and for 3 (8.1%) patients wire cannot be crossed. Although the mitral valve area calculated by cardiac catheterization increased significantly from immediately before 1.003±0.12cm2 to immediately after PBMV 1.73±0.23cm2 there was a no significant decrease in the mitral valve area at 6 months follow-up 1.66±0.22cm2 by Echocardiography.Conclusions: PBMV is an effective treatment for acquired mitral stenosis, as demonstrated by the immediate hemodynamic results in 37 consecutive procedures. PBMV is effective therapy with good midterm results for selected patients with mitral stenosis.

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Closed Mitral Valvotomy for Mitral Stenosis in Mirror Image Dextrocardia

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239500300211 ◽

1995 ◽

Vol 3 (2) ◽

pp. 75-77 ◽

Cited By ~ 1

Author(s):

Gutti Ramasubrahmanyam ◽

Dronamraju Dilip ◽

Pirovam Venkat Ramnarayan ◽

Raju Subramaniam Iyer ◽

Kothapalle Venugopal Naidu

Keyword(s):

Mitral Valve ◽

Surgical Approach ◽

Mitral Stenosis ◽

Mirror Image ◽

Abnormal Position ◽

Mitral Valve Area ◽

Anterolateral Thoracotomy ◽

Mitral Valvotomy ◽

Valve Area

A 22-year-old female with mirror image dextrocardia and rheumatic valvular mitral stenosis underwent closed mitral valvotomy using a Tubb's dilator with good results. Despite abnormal position of situs, the surgical approach was simple through right anterolateral thoracotomy, and the operator's hands were mirror image to that of levocardia valvotomy in certain steps. Preoperative mitral valve area was 0.8 cm2, and peak and mean diastolic gradients were 21 and 15 mmHg respectively. Postoperatively, valve area improved to 2.16 cm2, and peak and mean diastolic gradients were 8 and 3.1 mmHg, respectively.

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