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

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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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)

Indian Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s12055-006-0666-x ◽

2006 ◽

Vol 22 (1) ◽

pp. 80-80

Author(s):

KH Devendra Singh ◽

SM Reddy ◽

A Grover ◽

SKS Thingnam

Keyword(s):

Mitral Valve ◽

Pulmonary Artery ◽

Pulmonary Function ◽

Mitral Stenosis ◽

Pulmonary Artery Hypertension ◽

Mitral Valve Area ◽

Rheumatic Mitral Stenosis ◽

Percutaneous Balloon ◽

Mitral Valvotomy ◽

Valve Area

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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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A Study of Assessment of Mitral valve area before and after percutaneous balloon mitral valvuloplasty using Mitral leaflet separation index in a tertiary care center

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v6i7.178 ◽

2018 ◽

Vol 6 (7) ◽

Author(s):

Dr Ravishankar Govindarajulu ◽

Keyword(s):

Mitral Valve ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Mitral Leaflet ◽

Mitral Valvuloplasty ◽

Mitral Valve Area ◽

Percutaneous Balloon ◽

Before And After ◽

Valve Area

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Balloon Mitral Valvotomy in Gestational Women with Symptomatic Mitral Stenosis

Cardiology and Angiology An International Journal ◽

10.9734/ca/2020/v9i330134 ◽

2020 ◽

pp. 1-7

Author(s):

Prem Krishna Anandan ◽

Arun Kaushik ◽

K. Tamilarasu ◽

G. Rajendran ◽

Shanmuga Sundaram ◽

...

Keyword(s):

Mitral Valve ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Mitral Stenosis ◽

Intrauterine Growth Restriction ◽

Mitral Valvuloplasty ◽

Artery Pressure ◽

Mitral Valve Area ◽

Mitral Valvotomy ◽

Valve Area

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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PW360 Correlation of Echocardiographic Assessment of Mitral Valve Area with the Gorlin Formula in Patients with Mitral Stenosis undergoing Percutaneous Balloon Mitral Valvuloplasty

Global Heart ◽

10.1016/j.gheart.2014.03.2424 ◽

2014 ◽

Vol 9 (1) ◽

pp. e333

Author(s):

Samuel D. Hillier ◽

Arvin Lamanna ◽

Darren Walters ◽

David Platts

Keyword(s):

Mitral Valve ◽

Mitral Stenosis ◽

Mitral Valvuloplasty ◽

Mitral Valve Area ◽

Percutaneous Balloon Mitral Valvuloplasty ◽

Percutaneous Balloon ◽

Echocardiographic Assessment ◽

Valve Area

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Mid-term (up to 12 years) clinical and echocardiographic outcomes of percutaneous transvenous mitral commissurotomy in patients with rheumatic mitral stenosis

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02175-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yahya Dadjo ◽

Maryam Moshkani Farahani ◽

Reza Nowshad ◽

Mohsen Sadeghi Ghahrodi ◽

Alireza Moaref ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Stenosis ◽

Protective Factor ◽

Cardiac Events ◽

Mitral Valve Area ◽

Adverse Cardiac Events ◽

Percutaneous Transvenous Mitral Commissurotomy ◽

Mitral Commissurotomy ◽

Valve Area

Abstract 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 prophylaxis regimen or not. Those who had not suffered from the adverse cardiac events were additionally asked to undergo echocardiographic imaging, in order to assess the prevalence of mitral valve restenosis, defined as mitral valve area (MVA) < 1.5 cm2 and loss of ≥ 50% of initial area gain. Results During the mean follow-up time of 5.69 ± 3.24 years, 31 patients (16.6% of patients) had suffered from adverse cardiac events. Atrial fibrillation rhythm (p = 0.003, HR = 3.659), Wilkins echocardiographic score > 8 (p = 0.028, HR = 2.320) and higher pre-procedural systolic pulmonary arterial pressure (p = 0.021, HR = 1.031) were three independent predictors of adverse events and immediate post-PTMC mitral valve area (IMVA) ≥ 2 cm2 (p < 0.001, HR = 0.06) was the significant predictor of event-free outcome. Additionally, follow-up echocardiographic imaging detected mitral restenosis in 44 patients (23.6% of all patients). The only statistically significant protective factor against restenosis was again IMVA ≥ 2 cm2 (p = 0.001, OR = 0.240). Conclusion The mid-term results of PTMC are multifactorial and may be influenced by heterogeneous peri-procedural determinants. IMVA had a great impact on the long-term success of this procedure. Continuing secondary antibiotic prophylaxis was not a protective factor against adverse cardiac events in this study. (clinicaltrial.gov registration: NCT04112108).

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