Title: Percutaneous Balloon Mitral Valvuloplasty: To Share Our Experience
Authors: Indrajit Mandal, Malay Acharyay, Mainak Mukhopadhayay
DOI: http://dx.doi.org/10.18535/jmscr/v4i2.71
Objectives: We have conducted this study to share our experience with Percuteneous Ballooon Mitral Valvoplasty (PBMV). Materials and Methods: The study was conducted at N.R.S. and R.G.Kar Medical College over one year with 20 patients (16 female, 4 male) of severe mitral stenosis, underwent PBMV. Mean age was 22.6±7.13years. 14 patients were laborer, 3 from lower middle class and 3 from upper middle class. Majority (14) came from rural area. 3 from sub-urban area and rest were city slum dweller. Nine patients had symptoms of NewYork Heart Association Class IV, 10 patients had Class III and 1 had Class II symptoms. Three patients had previous surgical commissurotomy. Associated aortic stenosis was seen in 03 and coronary artery stenosis in 01. Two pregnant mothers were in the study. Thirteen patients had Mitral Valve Morphologic Score (MVMS) <8, MVMS was 10 in four, 11 in 02 and 12 in one patient. 19 patients had associated Mitral Regurgitation (MR). Trivial MR in 08 patients, grade 1 in 09, and two grade 2 in 02 patients. Left Ventricular Ejection Fraction (LVEF) was ≥ 55% in 13, <55% in 5, and ≤35% in 2 patients. Mean Mitral Valve Area and Trans Mitral Gradient (TMG) before operation were 0.91±0.13cm2 and 15.05±2.24 mm of Hg respectively. Doppler and 2D study were done immediately, after 48 hrs and 6m. Results: After the procedure mean MVA and mean TMG were 1.95 ±0.21 cm2 and 6.7±2.31 mm of Hg respectively. There is statistically significant increase in MVA (p=0.000) and TMG (p=0.000). The only complication that 5% of patients developed was hemipericardium. Conclusion: PBMV should be considered as one of the best alternative of open valvotomy owing to its simplicity, safety, effectiveness and less complications. Keywords: MVA, Mitral Stenosis, Mitral Regurgitation, PBMV, TMG. 1. Inoue K, Owaki T, Nakamura T, Kitamura F, Miyamoto N. Clinical application of transvenvous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984;87:394–402. 2. Turi ZG, Reyes VP, Raju BS, Raju AR, Kumar DN, Rajagopal P, Sathyanarayana PV, Rao DP, Srinath K, Peters P. Percutaneous balloon versus surgical close commissurotomy for mitral stenosis: a prospective, randomized trial. Circulation. 1991;83:1179 –1185. 3. Arora R, Nair M, Kalra GS, Nigam M, Khalilullah M. Immediate and long-term results of balloon and surgical closed mitral valvotomy: a randomized comparative study. Am Heart J. 1993;125:1091–1094. 4. Cohen DJ, Kurtz RE, Gordon Stephen P.F, Piana RN et al. PREDICTOR OF LONG TERM OUTCOME AFTER PERCUTANEOUS BALLOON VALVULOPLASTY. New Eng J. 1992; 327:1329-35. 5. NobuyoshiM, Arita T, Shirai Shin-ichi, H, Hamasaki N. Percutaneous Balloon Valvuloplasty: A review. Circulation. 2009;119:211-19. 6. Vivian M. A, Gerard T. W, Christopher Y. C, James D. T, et al. Echocardiographic Evaluation of Mitral Valve Structure and Function in Patients Followed for at Least 6 Months After Percutaneous Balloon Mitral Valvuloplasty. J Am Coli CardioI.1988;12:606-15) 7. Martinez-rios MA, Tovar S, Luna J, Eid-Lidt G. Percutaneous mitral commissurotomy. Cardiol Rev. 1999;7:108 –116.Abstract
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