scholarly journals Immediate Outcome of Percutaneous Balloon Mitral Valvotomy in Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal

2015 ◽  
Vol 12 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Nagma Shrestha ◽  
Yadav Kumar Dev Bhatta ◽  
Arun Maskey ◽  
Rabi Malla ◽  
Rajib Rajbhandari ◽  
...  
Keyword(s):  
Mitral Stenosis ◽  
Effective Procedure ◽  
Safety And Efficacy ◽  
National Heart ◽  
Percutaneous Balloon ◽  
History Of ◽  
Mitral Valvotomy ◽  
The Mean ◽  
Procedural Success ◽  
Rheumatic Heart

Background and Aim: Percutaneous balloon mitral valvotomy is well established as safe and effective procedure for patients with mitral stenosis due to Rheumatic Heart Disease. There are some retrospective studies on safety and efficacy of it in different subgroups of patients from our centre. Our study aims to assess the safety, efficacy and outcome of it in Shahid Gangalal National Heart Centre, Kathmandu, Nepal. Methods: A Single centre, prospective study was conducted from July 1st 2013 to June 31st 2014 in our centre. All the patients who underwent percutaneous balloon mitral valvotomy for moderate to severe mitral stenosis during the study period were included. Safety and efficacy of the procedure was analyzed. Results: There were 262 patients enrolled in the study among which 194 (74%) were females. Mean age of patients was 33.2±12.5 years. Seventy patients (26.7%) were in atrial fibrillation, six (2%) were pregnant, three (1%) had history of stroke, twelve (4.6%) underwent previous surgical or balloon commissurotomy. The mean left atrial pressure reduced from 26.8 ± 8.9 mmHg to 15.6 ± 7.2 mmHg (p < 0.05).The mean mitral valve area increased from 0.9 ± 0.17 cm2 to 1.6 ± 0.28 cm2 (p < 0.05). Forty nine patients (18.7%) developed moderate to severe mitral regurgitation. There was no mortality related to the procedure. The procedural success was achieved in 84% patients. Conclusion: Our study suggests that percutaneous balloon mitral valvotomy is a safe and effective procedure for symptomatic mitral stenosis patients.DOI: http://dx.doi.org/10.3126/njh.v12i1.12325 Nepalese Heart Journal Vol.12(1) 2015: 11-14 

scholarly journals Mitral Stenosis: Making the diagnosis

2021 ◽  
Vol 8 (5) ◽  
pp. 01-03
Author(s):  
Sandhya Venugopal ◽  
Ezra A. Amsterdam ◽  
Patricia Applegate ◽  
Muhammad Majid ◽  
Ali Abdulraheem Mahdi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Stenosis ◽  
Developing Nations ◽  
Ample Evidence ◽  
Percutaneous Balloon ◽  
The Us ◽  
History Of ◽  
Surgical Valve Replacement ◽  
Mitral Valve Calcification ◽  
Rheumatic Heart

The case of a 60-year-old man illustrates a number of important features of rheumatic heart disease (RHD). The patient’s age of presentation was late (>50 yo) and he had no history of predisposing condition for RHD but served in the South Pacific when he was in the US Navy. RHD was limited to mitral stenosis in this patient and his presentation of heart failure was late. His ECG revealed ample evidence of right ventricular enlargement, and echocardiography demonstrated severe mitral stenosis, enlarged right ventricle and right atrium and marked pulmonary hypertension. Because percutaneous balloon mitral valve commissurotomy was precluded by the degree of mitral valve calcification, he underwent successful surgical valve replacement with relief of symptoms. Although RHD is rarely encountered in North America and Europe, it remains a major cause of mortality in the developing nations.

HAIR PIN LOOP TECHNIQUE WITH THREE DIMENTIONAL SHAPE SUPPORTED STYLET FOR SUCCESSFUL BALLOON MITRAL VALVOTOMY IN A DIFFICULT CASE.

2020 ◽  
pp. 80-81
Author(s):  
Ramanand Prasad Sinha ◽  
Abhimanu Singh
Keyword(s):  
Mitral Valve ◽  
Mitral Stenosis ◽  
Difficult Case ◽  
Success Rates ◽  
Percutaneous Balloon ◽  
Double Curve ◽  
Loop Technique ◽  
Mitral Valvotomy ◽  
Procedural Success ◽  
Inoue Balloon

Percutaneous balloon mitral valvotomy using Accura or Inoue balloon is an effective treatment for patients with rheumatic mitral stenosis suitable for valvotomy . Procedural success rates are high in experience hand with success rates are more than 90 %. Inability to cross the mitral valve is one of the prime reasons for procedure failure . We are reporting a case of 35 year female with severe mitral stenosis with severe subvalvular thickness using hairpin loop with double curve support of stylet, where all traditional methods of crossing mitral valve get failed. Mitral valvotomy successfully performed with mitral valve area increase from 0.5 cm2 to 2.1 cm 2.

scholarly journals Mean Levels of B-type Natriuretic Peptide (BNP) in Patients with Mitral Stenosis Caused by Rheumatic Heart Disease

2021 ◽  
pp. 96-102
Author(s):  
Altaf Hussain ◽  
Faraz Farooq Memon ◽  
Iftikhar Ahmed ◽  
Syed Ahsan Raza ◽  
Lajpat Rai ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Natriuretic Peptide ◽  
Mitral Stenosis ◽  
Final Analysis ◽  
Severe Intensity ◽  
The Mean ◽  
Valvular Lesion ◽  
Rheumatic Heart ◽  
Valve Area

Objective: Mitral stenosis caused by rheumatic heart disease (RHD) is the most common cause of valvular lesion in adults and prevalent in developing countries like Pakistan. Higher natriuretic peptide (BNP) levels can be observed in patients with moderate to severe untreated mitral stenosis and are associated with higher rates of morbidity and mortality. That is why this study aims to determine the association between levels of pro-BNP with severity (mild. Moderate, and severe) of mitral stenosis. Patients and Methods: This was a clinical prospective study carried out in the department of adult cardiology, national institute of cardiovascular diseases, Karachi from 8th august 2019 to 7th February 2020. Total 68 patients of either gender with age between 25-70 years had mitral stenosis of moderate to severe intensity (mitral valve area ≤1.5 cm2), diagnosed on echocardiography were included for final analysis. A simple blood sample was taken for the assessment of pro-BNP levels. Questionnaire was used for demographic & clinical data collection and analysed using SPSS version 22.0. Results: The overall mean age of study subjects was 42.21±11.50 years, ranging from 25 – 70 years. Among them, females were prevalent (n = 43, 63.2%). The overall mean serum BNP level was 1071.12±807.26 pg/ml and the mean difference of serum BNP level was not significant among groups of gender, age, and diabetes mellitus with p>0.05. Significantly raised levels of BNP were observed in patients with severe mitral stenosis as compared to moderate mitral stenosis, p<0.05 Conclusion: In conclusion, the mean BNP levels were higher in patients with severe Mitral Stenosis. Therefore, BNP may be used to complement the clinical and echocardiographic assessments in patients with Mitral Stenosis.

scholarly journals Randomized study comparing safety and efficacy of one shot versus serial metal telescopic dilation technique in percutaneous nephrolithotomy

2017 ◽  
Vol 20 (2) ◽  
pp. 13-19
Author(s):  
Ganesh Bhakta Acharya ◽  
Anil Shrestha ◽  
Hari Bahadur KC ◽  
Robin Bahadur Basnet ◽  
Aravind Kumar Shah ◽  
...  
Keyword(s):  
Success Rate ◽  
Percutaneous Nephrolithotomy ◽  
Randomized Study ◽  
Access Time ◽  
Single Shot ◽  
Safety And Efficacy ◽  
Tract Dilation ◽  
History Of ◽  
Procedural Success ◽  
Group B

Introduction: Dilation of the track can be achieved by multiple incremental flexible Amplatz type, Alken metal telescoping dilators, or balloon in Percutaneous Nephrolithotomy (PCNL). Balloon dilator is the most expensive method. Both of the incremental dilation techniques are more time consuming with higher failure rates. Hence, a prospective randomized study was conducted to compare the safety and efficacy of “single shot” dilation of the nephrostomy tract by amplatz dilator with serial alken metallic telescopic dilation technique in PCNL. Methods: Of the 138 renal stone patients who underwent PCNL from January 2015 to December 2015, 100 patients were randomized into two groups. Serial tract dilation with alken metallic dilators was used in group A (n=50), and one shot dilation technique in Group B (n=50). The access tract dilation time, success rate, blood loss and complications were evaluated. Results: Both the groups were comparable in terms of mean age, location and size (largest diameter) of the stone (p>0.05). No difference was observed in the procedural success rate between groups A and B (96% v 94% respectively, p=0.64). Mean access time was similar in both groups (5.89+2.67 vs 4.98+2.0 mins, p=0.06). Complications between the groups were not significantly different. There were 6 patients with previous open stone surgery in both the groups. Previous open stone surgery did not impact procedural success rate, access time and complications in both groups. Conclusion: One-shot dilation technique is equally as effective, safe and well tolerated as metal telescopic dilation techniques even in patients with history of ipsilateral open stone surgery.

scholarly journals PBTV and PBMV in a Patient with CRHD

2016 ◽  
Vol 01 (01) ◽  
pp. 036-039
Author(s):  
Ramya Pechetty
Keyword(s):  
Atrial Fibrillation ◽  
Tricuspid Valve ◽  
Significant Drop ◽  
Post Procedure ◽  
2D Echocardiography ◽  
Percutaneous Balloon ◽  
Mitral Valvotomy ◽  
One Year ◽  
Rheumatic Heart

Case DetailsA 26 year old gentleman who is a known case of chronic rheumatic heart disease, presented with exertional breathlessness of 1 year duration. He underwent percutaneous balloon mitral valvotomy in 2004 for severe mitral stenosis. ECG showed atrial fibrillation with controlled ventricular rates. 2D Echocardiography showed severe mitral restenosis (MVA=0.8 cm2; MVG =18/12, Panel A), Organic tricuspid valve disease with severe tricuspid stenosis (TVG=13/8, Panel B) with mild tricuspid regurgitation. Balloon mitral and tricuspid valvotomy was done sequentially in this patient with Acura 28 balloon, inflated to 28mm across mitral valve and 18mm across tricuspid valve with wire in LV and RV apex respectively (Panel C and D). There was significant drop in the trans-Valvular gradients (Panel E and F). Procedure was uneventful. The post procedure course was unremarkable and the patient is doing well at one year follow up.

scholarly journals Strain imaging to assess early effects of successful percutaneous balloon mitral valvotomy on left atrium mechanics

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
N. Sravan K Reddy ◽  
K. Ranjan Shetty ◽  
M. Sudhakar Rao ◽  
M. Sree Madhurya Reddy
Keyword(s):  
Mitral Stenosis ◽  
Left Atrial ◽  
Assessment Tool ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Systolic Pulmonary Artery Pressure ◽  
Left Atrial Strain ◽  
Percutaneous Balloon ◽  
Mitral Valvotomy ◽  
Atrial Strain

Abstract Background Global left atrial strain (LA) has been used as a novel assessment tool to evaluate left atrial function. However, not much has been investigated to study the effect of percutaneous balloon mitral valvotomy (BMV) in patients with rheumatic severe mitral stenosis on global LA strain. We studied the relationship between global left atrial (LA) strain and severe mitral stenosis and the effect of BMV on LA strain. Results A total of 29 patients satisfying the criteria for severe mitral stenosis underwent balloon mitral valvotomy (67% females; mean age, 39.53 ± 11.78 years). Global left atrial strain was assessed by speckle tracking echocardiography before and after valvuloplasty. Global LA strain was impaired in patients with severe mitral stenosis and improved 24–48 h following BMV (13.4 ± .75% vs 17.37 ± 6.95%, p < 0.001). There was a significant decrease in mitral mean gradient (MMG) (16.94 ± 6.62 mmHg vs 8.19 ± 4.01 mmHg, p < 0.001) and systolic pulmonary artery pressure (sPAP) (47.84 ± 9.07 mmHg vs 36.88 ± 7.69 mmHg, p < 0.001) after BMV. Mitral valve area (MVA) (1.045 ± 0.17 cm2 vs 1.94 ± 0.22 cm2, p < 0.001) significantly increased after BMV. Results were compared with 30 age- and sex-matched healthy controls. Conclusion Global LA strain can be taken as an indicator of left atrial function, and its improvement following valvotomy may be taken as a good indicator of successful BMV.

scholarly journals Outcome of percutaneous balloon mitral valvotomy in Shahid Gangalal National Heart Centre, Kathmandu, Nepal

2014 ◽  
Vol 66 ◽  
pp. S132
Author(s):  
N. Shrestha ◽  
Y.K.D. Bhatta ◽  
A. Maskey ◽  
R. Malla ◽  
R. Rajbhandari ◽  
...  
Keyword(s):  
National Heart ◽  
Percutaneous Balloon ◽  
Mitral Valvotomy

scholarly journals Prevalence of Atrial Fibrillation in patients attending emergency department of Shahid Gangalal National Heart Centre, Kathmandu, Nepal

2016 ◽  
Vol 13 (1) ◽  
pp. 1-4
Author(s):  
Krishna Prasad Adhikari ◽  
Rabi Malla ◽  
Deepak Limbu ◽  
Binaya Kumar Rauniyar ◽  
Sudhir Regmi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Western World ◽  
National Heart ◽  
Clinical Presentations ◽  
The Mean ◽  
Rheumatic Heart ◽  
Demographic Features

Background and Aims: Atrial fibrillation (AF) is the most common sustained arrhythmia. This study aims to evaluate its prevalence in patients attending emergency department of tertiary care cardiac centre.Methods: It was a prospective observational study of 1012 consecutive patients who attended emergency department of Shahid Gangalal National Heart Centre from September 2014 to November 2014. Electrocardiogram, demographic features, diagnosis and clinical presentations were reviewed.Results: Among the 1012 patients, 553 (54.6%) were male and 459(45.4%) were female. Mean age was 52.13} 17 years. A total of 140 patients (13.8%) patients had AF. The mean age of patients with AF was 55 years. The prevalence of AF was higher in female than male (19.2% Vs 9.4%). Among the Rheumatic heart disease patients, seventy percentages of them had AF. Dyspnea was the commonest symptom of patients with AF followed by palpitation.Conclusion: The prevalence of AF in our study is higher than in western world mainly because of endemic rheumatic heart disease.Nepalese Heart Journal 2016; 13(1): 1-4

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