PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY

Objective: To compare the clinical, echocardiographic and angiographicvariables after PTMC in patients of mitral stenosis having echo score < 8 and $ 8. Place of study: Cardiology wardand echocardiography department of the Punjab Institute of Cardiology, Lahore. Duration of study: The study wasconducted from 15 of January 2006 till 30 th th of July 2006.Study Design: It was a comparative study. Materials &Methods Two hundred consecutive patients of mitral stenosis undergoing PTMC were studied. Patients were dividedin to two groups. Group I consisted of patient having echo score <8, while Group II contained patients having echo score$8. Results:The immediate clinical follow-up of 200 patients who underwent PTMC procedure was studied. Patientswere divided into 2 groups, Echo-Sc <8 (n=136) and Echo-Sc$8 (n=64). PTMC resulted in an increase in mitral valvearea from 1.0±0.3 to 2.0±0.6 cm2 in patients with Echo-Sc<8 and from 0.8±0.3 to 1.6±0.6 cm2 in patients with Echo-Sc$8 (P<0.0001). Procedural success was 83.5% for the overall group, with patients with Echo-Sc <8 having a higherprocedural success (93.4% versus 62.5%; P<0.0001). Thirty three (16.5%) patients had unsuccessful procedures.There was 1(0.5%) in-hospital death. Severe post- PTMC MR ($3 grade) occurred in 19(9.4%) patients, with grade IIIin 12 (6%) and grade IV in 7(3.5%). Emergent MVR was required in 3(1.5%) of 200 patients. Pericardial tamponadeoccurred in 2(1%) patients. Thromboembolic events (stroke) occurred in 2(1%) patients in the overall population. Finally1(0.5%) patient developed complete atrioventricular block. Conclusions: Patients with echo score less than 8 havea favourable outcome in terms of procedural success and post procedure complications as compared to patients withecho score $8.