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Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis

OBJECTIVES: To determine the changes produced in mitral valve morphology after Percutaneous Trans-Venous Mitral Commissurotomy. METHODS: Patients with mitral stenosis who underwent PTMC at the cardiology department of Lady Reading Hospital, Peshawar, Pakistan, from 2006-2016 were included in this st...

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Autores principales: Khan, Adnan, Shafiq, Ihtesham, Jan, Muneeb, Hassan, Zair
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Professional Medical Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794164/
https://www.ncbi.nlm.nih.gov/pubmed/33437259
http://dx.doi.org/10.12669/pjms.37.1.2446
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author Khan, Adnan
Shafiq, Ihtesham
Jan, Muneeb
Hassan, Zair
author_facet Khan, Adnan
Shafiq, Ihtesham
Jan, Muneeb
Hassan, Zair
author_sort Khan, Adnan
collection PubMed
description OBJECTIVES: To determine the changes produced in mitral valve morphology after Percutaneous Trans-Venous Mitral Commissurotomy. METHODS: Patients with mitral stenosis who underwent PTMC at the cardiology department of Lady Reading Hospital, Peshawar, Pakistan, from 2006-2016 were included in this study. All the data were manually obtained from the electronic medical record (M.F.E.). Wilkin’s echocardiographic scoring system was used to assess the severity of mitral valve thickness, leaflet mobility, valvular calcification, and Subvalvular disease. The student t-test was used for mean comparison. P-value < 0.05 was considered significant. RESULTS: Of the total 229 patients, males were 96(41.9%), and females were 133(58.1%). The mean [SD] age of the patients was 25 ± 11years. The total Wilkin score was 7 ±1.5. 151(65.9%) were in New York Heart Association (NYHA) functional class III, and 78(34.1%) were in NYHA class IV. There was no immediate change after PTMC in systolic myocardial velocities (SV) measured at the lateral tricuspid annulus. The 2D mitral valve area increased from 0.98±0.94 cm(2) to 1.78 ± 0.44 cm(2) (P=0.001). Left Atrium diameter was 5.16±0.75 mm prior to PTMC, significantly decreased to 4.7± 0.7 mm (p=0.005) after PTMC. Ejection fraction (Left Ventricular Ejection Fraction) changed from 60.45± 8.25 mm Hg to 62.76±10 mm Hg (p=0.001). Mean Right Ventricular Ejection Fraction (RVEF) of patients before PTMC was 48.7 ± 4.7%, did not change significantly immediately after PTMC. CONCLUSION: PTMC is associated with significant changes in mitral valve morphology in terms of splitting of the fused mitral commissures, increased MVA, improved leaflet excursion, and splitting of the subvalvular structures.
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spelling pubmed-77941642021-01-11 Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis Khan, Adnan Shafiq, Ihtesham Jan, Muneeb Hassan, Zair Pak J Med Sci Original Article OBJECTIVES: To determine the changes produced in mitral valve morphology after Percutaneous Trans-Venous Mitral Commissurotomy. METHODS: Patients with mitral stenosis who underwent PTMC at the cardiology department of Lady Reading Hospital, Peshawar, Pakistan, from 2006-2016 were included in this study. All the data were manually obtained from the electronic medical record (M.F.E.). Wilkin’s echocardiographic scoring system was used to assess the severity of mitral valve thickness, leaflet mobility, valvular calcification, and Subvalvular disease. The student t-test was used for mean comparison. P-value < 0.05 was considered significant. RESULTS: Of the total 229 patients, males were 96(41.9%), and females were 133(58.1%). The mean [SD] age of the patients was 25 ± 11years. The total Wilkin score was 7 ±1.5. 151(65.9%) were in New York Heart Association (NYHA) functional class III, and 78(34.1%) were in NYHA class IV. There was no immediate change after PTMC in systolic myocardial velocities (SV) measured at the lateral tricuspid annulus. The 2D mitral valve area increased from 0.98±0.94 cm(2) to 1.78 ± 0.44 cm(2) (P=0.001). Left Atrium diameter was 5.16±0.75 mm prior to PTMC, significantly decreased to 4.7± 0.7 mm (p=0.005) after PTMC. Ejection fraction (Left Ventricular Ejection Fraction) changed from 60.45± 8.25 mm Hg to 62.76±10 mm Hg (p=0.001). Mean Right Ventricular Ejection Fraction (RVEF) of patients before PTMC was 48.7 ± 4.7%, did not change significantly immediately after PTMC. CONCLUSION: PTMC is associated with significant changes in mitral valve morphology in terms of splitting of the fused mitral commissures, increased MVA, improved leaflet excursion, and splitting of the subvalvular structures. Professional Medical Publications 2021 /pmc/articles/PMC7794164/ /pubmed/33437259 http://dx.doi.org/10.12669/pjms.37.1.2446 Text en Copyright: © Pakistan Journal of Medical Sciences http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Khan, Adnan
Shafiq, Ihtesham
Jan, Muneeb
Hassan, Zair
Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis
title Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis
title_full Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis
title_fullStr Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis
title_full_unstemmed Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis
title_short Echocardiographic assessment before and after Percutaneous Transvenous Mitral Commissurotomy in patients with Rheumatic Mitral Stenosis
title_sort echocardiographic assessment before and after percutaneous transvenous mitral commissurotomy in patients with rheumatic mitral stenosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794164/
https://www.ncbi.nlm.nih.gov/pubmed/33437259
http://dx.doi.org/10.12669/pjms.37.1.2446
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