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Chronic disease
P2-318 Long-term (5–10 yrs) results of balloon mitral commissurotomy for rheumatic mitral stenosis
  1. Y P Devi1,
  2. P N S Haritha2,
  3. D Rajasekhar3,
  4. G Subramanyam3,
  5. P Vanajakshamma3,
  6. V kumar3,
  7. N reddy3,
  8. P K Rao3
  1. 1Kakatiya University, Warangal, India
  2. 2Jawaharlal Nehru Technological University, Hyderabad, India
  3. 3SVIMS, Tirupati, India

Abstract

Introduction Percutaneous mitral commissurotomy (PTMC) has been known as an effective therapeutic modality for moderate to severe mitral stenosis. However, long-term results and factors influencing late outcome after PTMC remain to be elucidated.

Methods Retrospective study of symptomatic severe MS patients who underwent PTMC from 1994 to 1999 in our cardiology unit to evaluate the immediate and long term echocardiographic results of PTMC in 158 patients was conducted. We did transthoracic and transoesophageal echocardio- graphic study of all symptomatic severe mitral stenosis patients. Those patients who underwent PTMC were selected for the study.

Results Males constituted 31% and Females were 68% of total patient population. The mean age of patients was 31.09±9.7 years. Peak mitral valve gradients increased from 8.9 mm Hg±4.3 at day one to 14.6 mm Hg±9.8 and 18.5±8.2 at 5 years and 10 years respectively. Mean MVG was 4.7±2.4 mm Hg on day one and 9.18±5.62 and 11.8±6.66 at 5 and 10 years respectively. All patients in AF were above 40Yrs. Successful PTMC was done in 94.89%. Acute complications were anterior leaflet tear, cardiac tamponade. Mortality immediately after PTMC (1- during MVR), at 10 yrs (3 - one case secondary to severe MR, one patient stroke related, one patient no cardiac cause). Emergency MVR was done in two patients. Failed PTMC was present in five cases; CMV was done in those cases.

Conclusion Restenosis after 10-year follow-up after successful PTMC, was influenced more by Pre PTMC LA size, mitral valve area, subvalvular fusion than on immediate post PTMC parameters.

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