Predictors of Success of Redo PTMC
Zafar Iqbal, Ussama Munir, Tahir Mukhtar Sayed, Sabahat Gul, Hammad Zafar, Furqan Yaqub Pannu, Shamila Afshan, Amna Shafqat
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ABSTRACT
Background: The
goal of this study is to investigate the factors that influence the
effectiveness of redo percutaneous Transvenous Mitral Commissurotomy (PTMC) and
to See how it affects MVA and echocardiographic parameters.
Methods: It was a single-center, retrospective research that took place at Cardiac Center QAMC
Bahawalpur from 3rd January to 31st
December 2020. All patients who had Redo PTMC had their medical records
reviewed. The pre- and post-procedure values for mitral valve area (MVA), left
atrial pressure (LA pressure), pulmonary artery systolic pressure (PASP), and
mitral regurgitation (MR) were compared.
Results:. Total 78 patients were enrolled , 28(36%) males and 50(64%) females
with a mean age 37.15± 2.63 enrolled age range between 25-45 years. Patients
were divided into two groups, the average age of in successful (Group I)
patients was 31.08±5.83 years and in un-successful (Group II) patients was
30.73±4.21. In Group-I, 18(64.3%) males and 30(60.0%) females as compare with
Group-2, 10(35.7%) males and 20(40%) female’s patients were enrolled. Both
groups were well matched in other demographic and echocardiographic
characteristics .
Findings of echocardiographic
parameter showed that there is difference in Mitral Valve Area in (successful
vs unsuccessful group) 1.69±0.11 vs 0.67±0.23 with p-value 0. 024.. The mean PA
pressure13.25±5.19 vs 23.25±6.55 and Mean LA Pressure 13.25±5.19 vs 23.25±6.55
with p-value 0.29 between pre and post-Redo PTMC was statistically significant
as p-value = 0.001. Conclusion: In
patients with mitral restenosis, PTMC is a viable, safe surgery with a high
success rate and tolerable morbidity. Repeat PTMC should be the procedure of
choice in individuals with poor echo scores and no concomitant illnesses. Redo
PTMC can be utilized as a palliative approach in patients with more severe
valvular and subvalvular deformity who are at high risk of morbidity and death
with MVR due to the presence of substantial concomitant conditions.
Keywords: PTMC Percutaneous transvenous mitral commissurotomy, MR Mitral Stenosis
Rheumatic heart disease, Valve area, Mitral stenosis PASP pulmonary
artery systolic pressure
ABSTRACT
Background: The
goal of this study is to investigate the factors that influence the
effectiveness of redo percutaneous Transvenous Mitral Commissurotomy (PTMC) and
to See how it affects MVA and echocardiographic parameters.
Methods: It was a single-center, retrospective research that took place at Cardiac Center QAMC
Bahawalpur from 3rd January to 31st
December 2020. All patients who had Redo PTMC had their medical records
reviewed. The pre- and post-procedure values for mitral valve area (MVA), left
atrial pressure (LA pressure), pulmonary artery systolic pressure (PASP), and
mitral regurgitation (MR) were compared.
Results:. Total 78 patients were enrolled , 28(36%) males and 50(64%) females
with a mean age 37.15± 2.63 enrolled age range between 25-45 years. Patients
were divided into two groups, the average age of in successful (Group I)
patients was 31.08±5.83 years and in un-successful (Group II) patients was
30.73±4.21. In Group-I, 18(64.3%) males and 30(60.0%) females as compare with
Group-2, 10(35.7%) males and 20(40%) female’s patients were enrolled. Both
groups were well matched in other demographic and echocardiographic
characteristics .
Findings of echocardiographic
parameter showed that there is difference in Mitral Valve Area in (successful
vs unsuccessful group) 1.69±0.11 vs 0.67±0.23 with p-value 0. 024.. The mean PA
pressure13.25±5.19 vs 23.25±6.55 and Mean LA Pressure 13.25±5.19 vs 23.25±6.55
with p-value 0.29 between pre and post-Redo PTMC was statistically significant
as p-value = 0.001. Conclusion: In
patients with mitral restenosis, PTMC is a viable, safe surgery with a high
success rate and tolerable morbidity. Repeat PTMC should be the procedure of
choice in individuals with poor echo scores and no concomitant illnesses. Redo
PTMC can be utilized as a palliative approach in patients with more severe
valvular and subvalvular deformity who are at high risk of morbidity and death
with MVR due to the presence of substantial concomitant conditions.
Keywords: PTMC Percutaneous transvenous mitral commissurotomy, MR Mitral Stenosis
Rheumatic heart disease, Valve area, Mitral stenosis PASP pulmonary
artery systolic pressure