PRE AND POST-MITRAL VALVE AREA AND RIGHT VENTRICULAR FUNCTION OF IMMEDIATE PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY (PTMC) IN PATIENTS WITH MITRAL VALVE SYSTEM
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Keywords
Mitral Valve Stenosis, Percutaneous Transvenous Mitral Commissurotomy, Mitral Valve Area, Right Ventricular Function, Echocardiography, Cardiovascular Intervention
Abstract
Objective: This study aimed to evaluate the immediate effects of Percutaneous Transvenous Mitral Commissurotomy (PTMC) on mitral valve area (MVA) and right ventricular function (RVF) in patients with severe mitral stenosis.
Methods: A quasi-experimental study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Karachi, from January 1, 2023, to June 30, 2023. Forty patients aged 30-80 years with severe mitral stenosis were included. Baseline and immediate post-procedural echocardiographic measurements of MVA and RVF were recorded. Data analysis included calculating means and standard deviations for continuous variables, and frequencies and percentages for categorical variables. Paired sample t-tests were used to compare pre and post-procedural MVA and RVF, with significance set at p<0.05.
Results: The mean age of participants was 36.32 ± 12.26 years; 27.5% were male and 62.5% female. The baseline MVA increased significantly from 0.9570 ± 0.280 cm² to 1.5475 ± 0.234 cm² post-PTMC (p=0.0001). RVF improved from 17.7000 ± 3.817 mm to 18.9250 ± 3.392 mm post-PTMC (p=0.012). Stratification by age, BMI, gender, smoking status, diabetes mellitus, and hypertension showed significant improvements in MVA and RVF across all categories.
Conclusion: PTMC significantly enhances MVA and RVF immediately post-procedure in patients with severe mitral stenosis. These findings support PTMC as an effective alternative to surgical interventions, particularly for high-risk surgical patients, and highlight the importance of RVF assessment in optimizing patient outcomes. The statistical analysis confirms the robustness of these improvements. Further research with larger, multicenter studies and extended follow-up is recommended to validate these results and explore long-term impacts.
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Asim Ali
Post Fellow Interventional Cardiology, National Institute Of Cardiovascular Diseases Karachi, Pakistan.
Aneel Ahmed
Post Fellow In Cardiac Imaging, National Institute Of Cardiovascular Diseases, Karachi Pakistan.
Deepak Lal
3FCPS Cardiology, National Insititute Of Cardiovascular Disease And Cardiologist At Zayed Military Hospital Abu Dhabi, United Arab Emirates.
Abdul Rahman
FCPS Cardiology, Post Fellow Critical Care Medicine, National Institute Of Cardiovascular Disease, Karachi Pakistan.
Zafar Iqbal
Post Fellow Cardiac Imaging, National Institute Of Cardiovascular Diseases Karachi Pakistan.
Rabel Hassan
Diagnostic Radiology Resident, Dr.Ruth K.M.Pfau/ Civil Hospital Karachi, Pakistan.