Value of the metallie commissurotome in complex mitral stenosis

Other Title(s)

تقييم دور مشرط الصمام المعدني في الضيق المركب للصمام الميترالي

Source

Suez Canal University Medical Journal

Publisher

Suez Canal University Faculty of Medicine

Publication Date

2001-10-31

Country of Publication

Egypt

No. of Pages

110

Main Subjects

Medicine

English Abstract

Twenty patients (15 females and 5 males) with calcific mitral stenosis and mitral restenosis underwent percutaneousmitralcommissurotomyduringthe period from January 1999 till October 1999 at Ain Shams University Hospitals, Cardiology department.

Patients with pliable mitral leaflets were not included in this study.

The total echocardiographic score was > 8/16 in seventeen out of nineteen.

One patient was excluded from the study because of tamponade which developed during trial of interatrial septal puncture.

Patients were divided according to the nature and pathology of the mitral valve into two groups: Group 1: included 12 patients with calcified mitral stenosis.

Group 2: Included 8 patients With mitral restenosis after previous commissurotomy or balloon valvuloplasty.

The caliber of the commissurotome was selected guided by the body surface area.

The result of percutaneous metallic mitral commissurotomy (PMMG) was considered to be optimal if the mitral valve area increased to a value > 1.5 cm2 together with an increase of> 25% of the predilatation mitral valve area، :The criteria ofoptimal results was achieved in 10 patients in group 1.

The AV pressure gradient decreased from 15.27 ± 5.47 2.07 ± 2.09 0ا mmHg.

The mitral valve area increased from 0.98 ± 0.2 to 2.05 ± 0.47 cm2.

The mean left atrial pressure dropped from 30.54 ± 5.78 to 16.8 ±5.77 mmllg.

All values were statistically significant.

In group 2, optimal outcome was achieved in 5 patients.

The AV pressure gradient decreased from 16.37 ± 6.02 to 5.25 ± 6.58 mmHg,: the mitral valve area increased from 1.05 ±0.19 to 1.85 ±0.22 cm2.

The mean left atrial pressure decreased from 28.75 ± 8.53 to 19.62 ± 8.55 mmllg.

All values were statistically significant.

Multivariate analysis showed no predictor area can be detected for optimal outcome of PMMC.

The following complications were encountered: 1-Mitral regurgitation: moderate to severe occurred in 2 patients (10%).

2-Atrial septal defect: occurred in 10 patients (50%).

Data Type

Conference Papers

Record ID

BIM-393162

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