Zafar Iqbal, Ussama Munir, Tahir Mukhtar Sayed, Sabahat Gul, Hammad Zafar, Furqan Yaqub Pannu, Shamila Afshan, Amna Shafqat

Predictors of Success of Redo PTMC

Zafar Iqbal, Ussama Munir, Tahir Mukhtar Sayed, Sabahat Gul, Hammad Zafar, Furqan Yaqub Pannu, Shamila Afshan, Amna Shafqat



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 

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