scholarly journals IMMEDIATE OUTCOMES OF PERCUTANEOUS TRANSLUMINAL MITRAL COMMISSUROTOMY IN PATIENTS OF MITRAL STENOSIS

1969 ◽  
Vol 4 (1) ◽  
pp. 393-398
Author(s):  
ABDUL WALI ◽  
MUSHTAQ AHMED ◽  
UMAIR ALI ◽  
HIKMATULLAH JAN ◽  
ADNAN MEHMOOD GUL ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Cardiac Tamponade ◽  
Mitral Stenosis ◽  
Cross Sectional Study ◽  
Hospital Death ◽  
Severe Mitral Regurgitation ◽  
Cross Sectional ◽  
Mitral Commissurotomy ◽  
Percutaneous Transluminal ◽  
Percutaneous Transluminal Mitral Commissurotomy

BACKGROUND: Percutaneous Transluminal Mitral Commissurotomy (PTMC) is the treatment ofchoice for mitral stenosis. Patients with valvular calcification, thickened fibrotic leaflets and subvalvularfusion have adverse immediate outcomes of PTMC.OBJECTIVE: To determine the frequency of immediate outcomes of percutaneous transluminal mitralcommissurotomy in patients of mitral stenosis.This is descriptive cross sectional study conducted in the Cardiology Unit Govt. Lady Reading HospitalPeshawar from Jan, 2008- Feb, 2012, five hundreds and seventy seven patients of mitral stenosis.METHODS: Mitral patients with or without pre existing mild mitral regurgitation admitted inCardiology Unit, Lady Reading Hospital, Khyber Teaching Hospital and Hayat Abad Medical ComplexPeshawar were included in the study. After performing PTMC according to the standard protocol, dataregarding failure of the procedure, severe mitral regurgitation, cardiac tamponade, thromboembolismand in-hospital death was recorded.RESULTS: Out of 577 patients, 220 (38.13%) were males and 357 (61.87%) were females. The meanage of the patients was 31.96±10.01 years. Failure of the procedure of PTMC was found in 38 (7%)patients, severe mitral regurgitation in 27 (5%) patients, cardiac tamponade in 1 (0.17%) patients,thromboembolism in 3 (0.52%) patients and In-hospital death occurred in 5 (0.867%) patients.CONCLUSION: PTMC is a safe and effective procedure with good immediate outcomes in patients ofmitral stenosis with favorable mitral valve morphology.KEY WORDS: Mitral stenosis, PTMC, BMV, Outcomes of PTMC.

scholarly journals FREQUENCY OF ACUTE MITRAL REGURGITATION IN POST PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY PATIENTS WITH SEVERE MITRAL STENOSIS

2022 ◽  
Vol 54 (4) ◽  
pp. 328-332
Author(s):  
Zuhaib Uddin ◽  
Zeeshan Shaikh ◽  
Naveed Ahmed Shaikh ◽  
Sanaullah Shaikh ◽  
Gian Chand ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Mitral Stenosis ◽  
Cross Sectional Study ◽  
Severe Mitral Regurgitation ◽  
Cross Sectional ◽  
Post Procedure ◽  
Number Of Patients ◽  
Acute Mitral Regurgitation ◽  
Percutaneous Transvenous Mitral Commissurotomy ◽  
Mitral Commissurotomy

Objectives: To determine the frequency of Acute Mitral Regurgitation in Post Percutaneous Transvenous Mitral Commissurotomy (PTMC) patients with severe mitral stenosis (MS). Methodology: A cross-sectional study was conducted at the Tabba Heart Institute, Karachi, Pakistan between September 2019 and April 2021. All patients irrespective of gender, aged between 19-80 years, and those who did not undergo PTMC were eligible to partake in the study. Patients with mitral regurgitation along with mitral stenosis, or those with clot in left atrium, or those suffering with the last stage of renal disease were excluded from the study. A predefined Proforma was used as a research instrument through which medical records of patients of PTMC are collected. The variables of the Proforma include patient’s age, name, sex, echo findings, treatment procedure, post-procedure data and complications. Results: A mean age of 40.6 ± 12.63 years was reported. 86 (81.9%) of the patients developed ‘no complications’, 15 (14.3%) of the PTMC patients suffered from ‘severe mitral regurgitation’, 2 (1.9%) had local hematoma, and one patient had a cardiac tamponade after the procedure. Only one patient died post-procedure. Post-stratification analysis showed that the majority of the female patients and 83% of the patients with no previous commissurotomy history did not have any complications. While a total of 14.7% who had no history of previous commissurotomy suffered from severe MR. Conclusion: Our study revealed that only a small number of patients who underwent PTMC suffered from severe mitral regurgitation. Overall, the procedure is safe with a good outcome.

scholarly journals Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis

2019 ◽  
Author(s):  
Ata Firouzi ◽  
Niloufar Samiei ◽  
Somayyeh Ahmadi ◽  
Nasim Naderi ◽  
Parham Sadeghipour ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Pregnant Women ◽  
Head Circumference ◽  
Apgar Score ◽  
Mitral Stenosis ◽  
The Mean ◽  
Mitral Commissurotomy ◽  
Percutaneous Transluminal ◽  
Radiation Time ◽  
Percutaneous Transluminal Mitral Commissurotomy

Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes of pregnant women with mitral stenosis who underwent PTMC. Methods: Thirty-one patients undergoing PTMC during pregnancy were enrolled in this study. The mitral valve area (MVA), the transmitral valve mean gradient (MVMG), and the severity of mitral regurgitation were assessed pre- and postprocedurally by transthoracic and transesophageal echocardiography. The radiation time was measured during the procedure. The patients were followed up during pregnancy, and the neonates were monitored for weight, height, the head circumference, the birth Apgar score, and the adverse effects of radiation for at least 12 months. Results: PTMC was successfully performed on 29 (93.5%) patients. No maternal death or pulmonary edema was reported. The mean MVA significantly increased (from 0.73±0.17 cm2 to 1.28±0.24 cm2; P<0.001), and the mean MVMG significantly decreased (from 19.62±5.91 mmHg to 8.90±4.73 mmHg; P<0.001) after the procedure. A significant decrease in the systolic pulmonary artery pressure was also detected. Mitral regurgitation did not increase in severity in 16 (51.6%) patients. There was no significant relationship between the Apgar score, weight, height, and the head circumference at birth and at the radiation time. Conclusion:  In our series, PTMC during pregnancy was a safe and effective procedure. Lowering the radiation time with low frame-count techniques confers a significant decrease in radiation-related complications.

scholarly journals Percutaneous Transluminal Mitral Commissurotomy in Nepalese children with Rheumatic Mitral Stenosis

2014 ◽  
Vol 10 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Manish Shrestha ◽  
Chandra Mani Adhikari ◽  
Urmila Shakya ◽  
Aayush Khanal ◽  
Shradha Shrestha ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Left Atrial Pressure ◽  
Mitral Valve Area ◽  
Mitral Commissurotomy ◽  
Percutaneous Transluminal ◽  
Percutaneous Transluminal Mitral Commissurotomy ◽  
Valve Area

Background: Rheumatic heart disease is one of the most common heart diseases in developing country; however rheumatic mitral stenosis in children is relatively rare. Percutaneous transluminal mitral commissurotomy is a well established therapeutic intervention for mitral stenosis in adults. The study is conducted to determine the efficacy and safety of PTMC in children with severe mitral stenosis. Methods: A single centre retrospective study is conducted over a 3 and half years period (from 16th November, 2009 to 15th May, 2013) in Shahid Gangalal National Heart Centre, Kathmandu, Nepal. All consecutive patients aged less than 15 years who underwent Percutaneous transluminal mitral commissurotomy for severe mitral stenosis were included. Mitral valve area, left atrial pressure and mitral regurgitation were compared pre and post procedure. Results: During the study period, 2237 patients underwent Percutaneous transluminal mitral commissurotomy. Among them 100 children less than 15 years of age were included. Successful results were obtained in 94 (94%) patients. Mitral valve area increased from 0.7±0.15 cm2 to 1.5±0.32 cm2 (p<0.001). A significant decrease in left atrial pressure was observed from 29±7.9 mmHg to 13.9±6.2 mmHg (p<0.001). There was no significant change in grade of post procedural mitral regurgitation. Conclusions: Percutaneous transluminal mitral commissurotomy in children with severe mitral `stenosis is safe, effective and should be considered as procedure of choice for childrens. Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 23-26 DOI: http://dx.doi.org/10.3126/njh.v10i1.9743

scholarly journals Congenital Absence of Pericardium: A Rare Case Associated with Severe Mitral Stenosis with Pulmonary Hypertension

1970 ◽  
Vol 3 (2) ◽  
pp. 222-225
Author(s):  
MI Zulkarnine ◽  
BMM Choudhury ◽  
MF Islam ◽  
N Ahmed
Keyword(s):  
Mitral Stenosis ◽  
Rare Case ◽  
Congenital Absence ◽  
Pericardial Defect ◽  
Anterolateral Thoracotomy ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy ◽  
Percutaneous Transluminal ◽  
Absent Pericardium ◽  
Percutaneous Transluminal Mitral Commissurotomy

We report a rare case of congenital absence of pericardium in a 35 year old middle-aged man, who underwent closed mitral commissurotomy done for severe mitral restenosis developed after Percutaneous Transluminal Mitral Commissurotomy (PTMC) six months back. Operation was done under General Anaesthesia through left anterolateral thoracotomy. Pericardial defect was discovered intraoperatively. There was no clinical symptom that could be clearly related to the defect of the pericardial sac pre-operatively. The recovery of the patient was satisfactory and uneventful. Key Words: Mitral stenosis; Absent pericardium. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9193 Cardiovasc. J. 2011; 3(2): 222-225

scholarly journals ASSESSMENT OF COMMISSURAL MORPHOLOGY BY 2-DIMENSIONALAND 3- DIMENSIONAL ECHOCARDIOGRAPHY TO PREDICT THE IMMEDIATE OUTCOME OF PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY IN PATIENTS WITH RHEUMATIC MITRAL STENOSIS

2020 ◽  
pp. 1-3
Author(s):  
Jeet Ram Kashyap ◽  
Kewal Chand Goswami ◽  
Rakesh Yadav ◽  
Ganesan Karthikeyan ◽  
Neeraj Parakh ◽  
...  
Keyword(s):  
Mitral Stenosis ◽  
Three Dimensional ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Rheumatic Mitral Stenosis ◽  
3D Echo ◽  
Percutaneous Transvenous Mitral Commissurotomy ◽  
Mitral Commissurotomy ◽  
Dimensional Echocardiography

OBJECTIVE To find various commissural morphologic predictors of immediate outcome of percutaneous transvenous mitral commissurotomy by two and three dimensional echocardiography. METHODS Design: Cross sectional study Setting: Teratiry care hospital Participants: Symptomatic patients with severe rheumatic mitral stenosis aged more than 12 years without any contraindications for the procedure. Intervention: 2D and 3D echocardiographic evaluation of commissural morphology was done by measuring commissural thickness score, commissural fusion score, commissural calcification and intercommissural distance. End point: Predictors of successful procedure. RESULTS Sixty-five patients were screened. Ten were excluded because of (commissural calcification 5, > moderate mitral regurgitation 2, thrombus in left atrium 2 and emergency procedure in a pregnant lady 1). Fifty five patients (29 (53%) men and 26 (47%) women), mean age 30.58 ± 9.27 were studied. The procedure was successful in 47 (86%) patients. The following parameters predicted the success; lower commissural fusion score by 3D echo 1.5 (0.5 – 2.0) vs. 2.0 (0.5 -2.0); p ≤ 0.002, higher intercommissural distance by 2D echo 19.0 (12.5 – 21.5) vs. 16.5 (12.0 – 18.5); p ≤ 0.009, lesser commissural thickness score 3D echo 5.0 (0.4 – 10.2) vs. 8.8 (3.9 – 10.0); p ≤ 0.028 as well as by 2D echo 5.1 (1.7 - 9.8) vs 8.5 (4.3 - 9.7); p < 0.037. Commissural thickness score by 2D echo was the best predictor of outcome (r=0.509, P<0.0001). CONCLUSIONS Comissural morphology is an important independent predictor of immediate outcome of percutaneous transvenous mitral commissurotomy.

scholarly journals Closed Mitral Commissurotomy (CMC) at Bangabandhu Sheikh Mujib Medical University - Outcome Study

1970 ◽  
Vol 6 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Zerzina Rahman ◽  
Mostafa Nuruzzaman ◽  
Nazib Ahsan ◽  
Ayesha Sultana ◽  
Rezwanul Hoque ◽  
...  
Keyword(s):  
Mitral Stenosis ◽  
Low Cost ◽  
Mitral Commissurotomy ◽  
Severity Of The Disease ◽  
Closed Mitral Commissurotomy ◽  
Medical University ◽  
Inflammatory Changes ◽  
Percutaneous Transluminal ◽  
Percutaneous Transluminal Mitral Commissurotomy ◽  
Rheumatic Valvular Disease

Mitral stenosis (MS) occurs nearly exclusively as a consequence of rheumatic fever. The rheumatic process evokes the inflammatory changes in the valve endothelium resulting in narrowing of the orifice. Depending upon the severity of the disease, the treatment modality varies and the choice may be either Percutaneous transluminal mitral commissurotomy (PTMC), Closed mitral commissurotomy (CMC), Open mitral commissurotomy or valvuloplasty (OMC) or straight a way mitral valve replacement (MVR) procedure. In this observational study the results of 25 CMC operations done from February ‘09 through September ’09 is presented. A review of results of CMC operations done abroad is also presented. The outcome of this low cost operation for early cases of mitral stenosis is quite satisfactory.Keyword: Rheumatic valvular disease; Closed mitral commissurotomy; immediate outcome DOI: 10.3329/uhj.v6i2.7249University Heart Journal Vol. 6, No. 2, July 2010 pp.78-81

scholarly journals Percutaneous transluminal coronary angioplasty in Nepalese diabetic patients: Do they carry extra risk to revascularization process?

2012 ◽  
Vol 1 (1) ◽  
pp. 16-20
Author(s):  
F Khatun ◽  
B Rawat ◽  
A Vaidya ◽  
S Rajbhandari ◽  
Y Bhatta
Keyword(s):  
Coronary Angioplasty ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Cross Sectional Study ◽  
Hospital Death ◽  
Diabetic Patients ◽  
Success Rates ◽  
Cross Sectional ◽  
Medical College ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal

Background and Objectives: There is evidence that diabetes carries risk of various complications and adverse outcome with coronary revascularisation procedures. The aim of this study was to analyze the outcomes and complications of Percutaneous Transluminal Coronary Angioplasty in Nepalese diabetic patients compared to non-diabetic patients. Method: A hospital-based comparative cross-sectional study was conducted at Norvic International Hospital, Kathmandu, Nepal. A total of 702 consecutive Percutaneous Transluminal Coronary Angioplasty patients coming to the hospital from 2002 to 2010 were included. Angioplasty was performed using radial and femoral routes in a standard setting with standard techniques. Information on other background risk factors was recorded. Success of the procedures and presence of major and minor complications were observed. Results: Of the 702 patients participating in this study, 259 were diabetic and 443 were non-diabetic. Success rates were similar: 256 (98.8%) of diabetic and 438 (98.8%) of non-diabetic had a successful Percutaneous Transluminal Coronary Angioplasty. Complications of the procedure were however higher in the diabetic patients with higher in-hospital death (odds ratio 3.4, 95% confidence Interval: 0.6-19.1), compared to non-diabetic patients. Conclusion: The overall outcome of Percutaneous Transluminal Coronary Angioplasty was equally successful in diabetic and non-diabetic populations groups. But the complications were higher with the diabetic group which were because of presence of other co-morbidities in this group and were not procedure-related. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7250 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.16-20

Role of Closed Mitral Commissurotomy for Mitral Stenosis: Mid- and Long-term Surgical Outcome of 36 Patients

2005 ◽  
Vol 8 (1) ◽  
pp. 55 ◽  
Author(s):  
Azman Ates ◽  
Yahya �nl� ◽  
Ibrahim Yekeler ◽  
Bilgehan Erkut ◽  
Yavuz Balci ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Stenosis ◽  
Operating Time ◽  
Term Survival ◽  
Long Term Outcome ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

Purpose: To evaluate long-term survival and valve-related complications as well as prognostic factors for mid- and long-term outcome after closed mitral commissurotomy, covering a follow-up period of 14 years. Material and Methods: Between 1989 and 2003, 36 patients (28 women and 8 men, mean age 28.8 6.1 years) underwent closed mitral commissurotomy at our institution. The majority of patients were in New York Heart Association (NYHA) functional class IIB, III, or IV. Indication for closed mitral commissurotomy was mitral stenosis. Closed mitral commissurotomy was undertaken with a Tubbs dilator in all cases. Median operating time was 2.5 hours 30 minutes. Results: After closed mitral commissurotomy, the mitral valve areas of these patients were increased substantially, from 0.9 to 2.11 cm2. No further operation after initial closed mitral commissurotomy was required in 86% of the patients (n = 31), and NYHA functional classification was improved in 94% (n = 34). Postoperative complications and operative mortality were not seen. Follow-up revealed restenosis in 8.5% (n = 3) of the patients, minimal mitral regurgitation in 22.2% (n = 8), and grade 3 mitral regurgitation in 5.5% (n = 2) patients. No early mortality occurred in closed mitral commissurotomy patients. Reoperation was essential for 5 patients following closed mitral commissurotomy; 2 procedures were open mitral commissurotomies and 3 were mitral valve replacements. No mortality occurred in these patients. Conclusions: The mitral valve area was significantly increased and the mean mitral valve gradient was reduced in patients after closed mitral commissurotomy. Closed mitral commissurotomy is a safe alternative to open mitral commissurotomy and balloon mitral commissurotomy in selected patients.

scholarly journals Liver Biomarkers Assay in COVID-19 Cases: A Comparison Study between Alive and Dead Patients

2022 ◽  
Author(s):  
Amir Emami ◽  
Fatemeh Javanmardi ◽  
Ali Akbari ◽  
Babak Shirazi Yeganeh ◽  
Tahereh Rezaei ◽  
...  
Keyword(s):  
Serum Albumin Level ◽  
Critical Role ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Albumin Level ◽  
Hospital Death ◽  
Comparison Study ◽  
Sectional Study ◽  
Laboratory Findings ◽  
Cross Sectional

Background: Identifying effective biomarkers plays a critical role on screening; rapid diagnosis; proper managements and therapeutic options, which is helpful in preventing serious complications. The present study aimed to compare the liver laboratory tests between alive and dead hospitalized cases for prediction and proper management of the patients. Methods: This retrospective, cross sectional study consists of all deceased patients admitted in one center in Shiraz, Iran during 19 Feb 2020 to 22 Aug 2021. For further comparison, we selected a 1:2 ratios alive group randomly. Results: Overall, 875 hospitalized cases died due to COVID-19. We selected 1750 alive group randomly. The median age was significantly higher in died group (65.96 vs 51.20). Regarding the laboratory findings during the hospitalization ALT, AST, Bili.D were significantly higher in non-survivors than survivors but Albumin was less in deceased patients. It was revealed elevated levels of Albumin, AST, Bili.T and Bili.D were associated with increasing the risk of in hospital death. Moreover, the predictive effect of ALP and Bili.D had significantly more than others with high sensitivity and specify. Conclusion: We found patients with COVID-19 have reduced serum albumin level, and increase ALT and AST. The current results revealed abnormal liver chemistries is associated with poor outcome, which highlighted the importance of monitoring these patients more carefully and should be given more caution.

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