Percutaneous transvenous mitral commissurotomy in mitral stenosis and left atrial appendage clot patients in special conditions: Hospital-based study

Rajbhandari, Rajib; Malla, Rabi; Maskey, Arun; Bhatta, Yadav Kumar Deo; Limbu, Yubraj; Sharma, Ranjit; Singh, Satish; Adhikari, Chandra Mani; Mishra, Sundeep

doi:10.1016/j.ihj.2016.04.020

Cited by 5 publications

(3 citation statements)

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“…Intraoperative echocardiography plays an important role in evaluating the immediate results of the BMV MVS, with the help of which it is possible to accurately determine the area of the mitral orifice after each stage of mitral orifice expansion, the degree of opening of intercommissural adhesions, the dynamics of the transmitral gradient, the state of regurgitation on the mitral valve, which are important for early diagnosis of possible complications [13,14].…”

Section: Resultsmentioning

confidence: 99%

Clinical outcomes of percutaneous balloon valvuloplasty in patients with critical mitral stenosis

Salakhitdinov¹,

Khaydarov²

2023

GSC Adv. Res. Rev.

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Background: Clinical outcomes after percutaneous balloon valvuloplasty in patients with critical mitral stenosis is challenging and widely discussed. Aim of the study was to analyze the results of balloon mitral valvuloplasty (BMV) using the Inoue technique in patients with critical mitral valve stenosis. Material and Methods: From January 2020 to 2022, balloon mitral valvuloplasty was performed in 31 patients with critical mitral valve stenosis using the Inoue technique. There were 14 men (45.2%), women - 17 (54.8%). The patients were aged from 19 to 59 years, on average 42.4±6.1 years. All patients data were analyzed to evaluate the possible outcomes. Results: In 30 (96.4%) patients, a successful BMV was performed. In 1 (3.2%) patients, PMV failed, including puncture was unsuccessful, and it was not possible to pass a balloon catheter from the LA to the LV through the critically narrowed mitral valve opening. These failures took place at the initial stages of mastering the technique. A lethal outcome was noted in 0 (0.0%) case. In all 30 (96.8%) patients after BMV, positive results were obtained: the area of the mitral orifice increased by an average of 2.5 times, from 0.85±0.17 to 2.16±0.76 cm2 (p< 0.001), the maximum gradient at the level of the mitral valve decreased by 60.5%, on average from 26.9±2.95 to 8.9±0.6 mm Hg. (p<0.0001). The maximum pressure in the LA statistically significantly decreased from 40.29±6.01 mm Hg. Art. up to 21.43±3.83 mm Hg (p<0.05), in LA - from 49.7±10.9 to 29.7±8.2 mm Hg. (p<0.05). According to EchoCG data, regurgitation on the mitral valve after BMV appeared in 6 (24.1%) patients up to I degree, in 1 (3.2%) - up to II, and in 1 (3.2%) - up to III. In 16 (61.5%) of 26 patients with initial mitral insufficiency after BMV, the degree of regurgitation remained at the same level, in 8 (30.7%) the latter increased to II, in 2 (7.7%) - to III degree. Conclusion: BMV using the INOUE technique is a highly effective minimally invasive treatment method, accompanied by a low morbidity and mortality rate.

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Section: Resultsmentioning

confidence: 99%

Clinical outcomes of percutaneous balloon valvuloplasty in patients with critical mitral stenosis

Salakhitdinov¹,

Khaydarov²

2023

GSC Adv. Res. Rev.

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“…The age distribution and female preponderance of our patients were similar to other studies from developing countries. [2526]…”

Section: Discussionmentioning

confidence: 99%

Assessment of quality of life before and after successful percutaneous transvenous mitral commissurotomy in patients with severe mitral stenosis

et al. 2019

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Background:Rheumatic mitral stenosis (MS) is a significant cause of morbidity and mortality in India. Percutaneous transvenous mitral commissurotomy (PTMC) has become the procedure of choice for severe MS with pliable leaflets. Despite a wealth of literature on the technical aspects of PTMC, there is a dearth of literature addressing the impact of PTMC on the quality of life (QOL).Aim:The aim of the study is to assess the impact of PTMC on clinical status and QOL of patients with severe MS.Materials and Methods:Twenty-five consecutive patients with severe MS undergoing PTMC were included in the study with their informed consent. All patients were subjected to routine blood tests, electrocardiogram, chest X-ray, two-dimensional and color echocardiography, treadmill test (TMT), and World Health Organization (WHO) QOL scale. The echocardiography, TMT, and WHOQOL scale were repeated after the procedure.Results:The procedural success was 98%. The mean (range) mitral valve area preprocedure was 0.82 (0.59–0.92) cm2 and postprocedure was 1.61 (1.51–1.76) cm2. The difference was statistically significant (t = 5.02; P < 0.01). The mean (range) of TMT preprocedure was 4.05 (3.0–7.0) METS and postprocedure was 8.52 (6–12) METS. The difference was statistically significant (T = 3.08; P < 0.01). The mean (range) of QOL assessment pre- and post-procedure on physical domain was 8.83 (8.3–10.1) which increased to 11.11 (10–12.7); on social relationship domain from 9.17 (7.5–12.4) to 11.37 (9.4–12.0); on personal relationship from 11.6 (11–13) to 12.52 (12–13); on environment domain from 10.78 (10.2–11.7) to 11.56 (10.8–12); and on level of independence from 9.02 (8–10) to 12.29 (11.0–13.6). All the differences were statistically significant (Wilcoxon signed-rank test z = −4.376; −4.379; −4.234; −4.200; −4.375; respectively, all P < 0.001 highly significant).Conclusions:PTMC resulted in a significant improvement in the QOL of patients with severe MS. The significant improvement in QOL post-PTMC may be an indication for offering PTMC at an earlier stage to those patients whose QOL is severely compromised.

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“…Contraindications have generally included the presence of thrombus in the LAA and more than mild MR. With regard to the former, there have been a number of reports as well as some series where PBMV was performed despite documented LAA thrombus. 32 Most operators defer intervention until a prolonged period of anticoagulation to allow for resolution of thrombus; in the author’s opinion, the ability to keep hardware from entering the appendage, even by highly skilled operators, is imperfect and potentially exposes patients to unnecessary risk of stroke. More than mild MR has been considered a relative contraindication (although some operators will routinely do PBMV in patients with mild to moderate or moderate MR); it is important to note that a 1 grade increase in MR, even with ideal commissural splitting, is common and should be expected; hence, the risk of severe MR may be substantial.…”

Section: Interventionmentioning

confidence: 99%

The 40th Anniversary of Percutaneous Balloon Valvuloplasty for Mitral Stenosis: Current Status

Turi¹

2022

Structural Heart

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Percutaneous transvenous mitral commissurotomy in mitral stenosis and left atrial appendage clot patients in special conditions: Hospital-based study

Abstract: The immediate result of percutaneous transvenous mitral commissurotomy in selected cases of mitral stenosis with left atrial appendage clot is safe and acceptable in certain urgent situations in experienced hands.

Cited by 5 publications

References 8 publications

Clinical outcomes of percutaneous balloon valvuloplasty in patients with critical mitral stenosis

Clinical outcomes of percutaneous balloon valvuloplasty in patients with critical mitral stenosis

Assessment of quality of life before and after successful percutaneous transvenous mitral commissurotomy in patients with severe mitral stenosis

The 40th Anniversary of Percutaneous Balloon Valvuloplasty for Mitral Stenosis: Current Status

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