Percutaneous transatrial mitral commissurotomy: Immediate and intermediate results

Arora, Ramesh; Kalra, Gagan; Murty, G.S.R.; Trehan, Vijay; Jolly, Neeraj; Mohan, Jagdish C.; Sethi, K K; Nigam, M; Khalilullah, M

doi:10.1016/0735-1097(94)90374-3

Cited by 104 publications

(57 citation statements)

References 37 publications

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“…Previous studies have confirmed that this procedure is highly successful with a low complication rate and significant short-and long-term improvement in both hemodynamics and patient symptoms. [14][15][16] The present study demonstrates that PTMC produces significant morphologic and hemodynamic changes in the mitral valve. We found that PTMC produced a significant increase in MVA and a significant splitting of both mitral commissures.…”

Section: Discussionmentioning

confidence: 81%

Effect of Mitral Valve Leaflets Excursion on Mitral Valve area after Percutaneous Trans- Venous Mitral Commissurotomy

et al. 2017

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Background: Aim of our study was to predict the effect of mitral valve leaflets excursion on mitral valve area following percutaneous transvenous mitral commissurotomy PTMC in patients of mitral stenosis.Methods: Total 70 patients with severe mitral stenosis who underwent PTMC were enrolled in the study.Transthoracic echocardiography was done the day before PTMC and 24-48 hours after PTMC. Mitral valve area, anterior and posterior leaflets excursion were recorded. The relation between leaftlet excursion and mitral valve after PTMC was evaluated.Results: Following PTMC there were significant increasein anterior leaflet excursion from 1.9 ± 0.2 to 2.3 ± 0.2cm (p<0.001), posterior leaflet excursion from 1.6±0.2to1.9 ± 0.2cm (p<0.001). Mitral valve areas increased from 0.8 ± 0.1 to1.7 ± 0.2cm²(p<0.001). Both leaflet excursion increased significantly with the increase in mitral valve area till the area reached a value of about 1.5 cm2, after which any further increase in mitral valve area was not associated with any further increase in leaflet excursion.Conclusion: PTMC is associated with immediate significant changes in mitral valve morphology in terms of splitting of fused mitral commissures, increased leaflets excursion and splitting of the subvalvular structures. Post PTMC leaflet excursion increases significantly with the increase in mitral valve area till the area reaches a value of about 1.5 cm2 after which any further increase in mitral valve area is not associated with any further increase in leaflet excursion.Cardiovasc. j. 2017; 10(1): 3-7

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Section: Discussionmentioning

confidence: 81%

Effect of Mitral Valve Leaflets Excursion on Mitral Valve area after Percutaneous Trans- Venous Mitral Commissurotomy

et al. 2017

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“…A recent report reviewing transatrial mitral commissurotomy in 600 patients with rheumatic mitral stenosis cited a very low left atrial perforation rate of I %. 15 Left atrial enlargement has been felt to attenuate the risk of atrial perforatione6 However, distorted septal anatomy may also increase the inadvertent perforation rate, for example, when certain valvular diseases displace the fossa ovalis from its normal position ( e g , in mitral stenosis, the fossa is usually displaced inferiorly).1s Multivariate analysis is required to verify whether the risk of atrial perforation during transseptal catheterization increases or decreases depending upon whether there is atrial dilatation and associated septal anatomy distortion or whether atria are normal.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal echocardiographically guided atrial transseptal catheterization in patients with normal‐sized atria: Incidence of complications

Hahn

Gal

Sarnoski

et al. 1995

Clinical Cardiology

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Summary:The incidence of cardiac complications from atrial transseptal catheterization has never been quantified in patients with normal-sized atria. Series defining the complication rate are derived from diseased hearts with structural changes that may alter the complication rate of the procedure. The generation of a standardized incidence of perforation in a population of structurally normal atria ha3 important implications. A total of 46 atrial Vansseptal catheterizations guided by transesophageal echocardiography (TEE) for radiofrequency ablation of left-sided accessory pathways was performed in 42 patients during a 3-year period (199c-1993). Clinical and echocardiographic data were analyzed, with special attention given to TEE reports pre-and post-transseptal catheterization. Only one coniplication occurred in the 46 procedures (2.2%): a perforation of the left atrium that led to pericardial effusion and cardiac tamponade. In a small series of patients with normalsized atria, we have demonstrated that TEE-guided transseptal catheterization is a procedure with a low complication rate.

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“…• Sucesso: aumento da área valvar ≥ 25% da área inicial e área valvar mitral final ≥ 1,5 cm², na ausência de insuficiência mitral grave [6][7][8][9][10][11] .…”

Section: Definiçõesunclassified

“…• Reestenose ecocardiográfica: área valvar mitral no seguimento tardio, avaliada pela planimetria e/ou pelo tempo de meia pressão (PHT), < 1,5 cm², com perda ≥ 50% do ganho inicial [7][8][9] .…”

Section: Definiçõesunclassified

Valvotomia mitral percutânea: da primeira à terceira dilatação

Gomes¹,

Esteves²,

Braga³

et al. 2009

Rev. Bras. Cardiol. Invasiva

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RESUMOIntrodução: As causas de reestenose pós-valvotomia mitral percutânea dependem principalmente das características da população submetida à técnica. O objetivo deste trabalho foi comparar os resultados imediatos e tardios dos pacientes submetidos a dois ou mais procedimentos de valvotomia mitral percutânea (VMP) a um grupo de pacientes submetidos apenas a uma dilatação para o tratamento da estenose mitral grave. Método: Os pacientes foram divididos em dois grupos: o grupo A incluiu 90 pacientes submetidos a uma primeira VMP e que, em decorrência de reestenose ecocardiográfica e clínica, foram encaminhados a uma segunda intervenção, e 9 pacientes que, pelo mesmo motivo, foram submetidos a um terceiro procedimento; e grupo B, composto de 90 pacientes selecionados por amostra aleatória simples submetidos a apenas uma dilatação, todas com sucesso. As variáveis ecocardiográficas analisadas para comparação dos resultados dentro do mesmo grupo e entre os grupos A e B foram a área valvar mitral (AVM), os gradientes diastólicos máximo (GDM) e médio (GDm), o diâmetro do átrio esquerdo e a incidência de reestenose. Resultados: Nos pacientes do grupo A, a primeira dilatação foi realizada com sucesso em 87 (96,7%) pacientes. Comparativamente, a média das áreas valvares após a primeira dilatação dos pacientes que compõem o grupo A foi menor que a dos pacientes do grupo B (1,97 ± 0,17 cm² vs. 2,10 ± 0,33 cm²; P = 0,011). Em ambos os grupos, não se observou diferença estatisticamente significante, pré e imediatamente após o primeiro procedimento, na redução da média do GDM e do GDm e na média dos diâmetros do átrio esquerdo. Nos pacientes do grupo A, após a segunda valvotomia, os critérios de sucesso foram alcançados em 77 (85,5%) pacientes. A média das áreas valvares, nessa oportunidade, foi menor que após a primeira intervenção (1,83 ± 0,28 cm² vs. 1,97 ± 0,17 cm²; P < 0,005). Ainda dentro desse mesmo grupo, observou-se queda significativa do GDM e do GDm quando comparados os valores após o primeiro e o segundo procedimentos. Uma ABSTRACT Percutaneous Mitral Balloon Valvotomy: from the First to Third DilatationBackground: The causes for restenosis following percutaneous balloon mitral valvotomy (PBMV) vary according to the population undergoing this technique. The aim of this study was to compare the immediate and long-term results of patients undergoing a second and third PBMV to patients submitted to a single dilatation of the mitral valve for the treatment of severe mitral stenosis. Methods: Patients were divided into two groups: group A with 90 patients who, due to clinical and echocardiographic restenosis, were submitted to more than one procedure, and group B with 90 patients, selected by a random sample who underwent a single successful procedure. The echocardiographic variables analyzed to compare the results in the same group and between groups A and B were mitral valve area (MVA), maximal and mean diastolic gradients, left atrial diameter and incidence and time to restenosis. Results: In group A, the first dilat...

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Percutaneous transatrial mitral commissurotomy: Immediate and intermediate results

Abstract: Percutaneous transatrial mitral commissurotomy is an effective, safe procedure with gratifying intermediate results. It should be considered the treatment of choice for rheumatic mitral stenosis.

Cited by 104 publications

References 37 publications

Effect of Mitral Valve Leaflets Excursion on Mitral Valve area after Percutaneous Trans- Venous Mitral Commissurotomy

Effect of Mitral Valve Leaflets Excursion on Mitral Valve area after Percutaneous Trans- Venous Mitral Commissurotomy

Transesophageal echocardiographically guided atrial transseptal catheterization in patients with normal‐sized atria: Incidence of complications

Valvotomia mitral percutânea: da primeira à terceira dilatação

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