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الأربعاء 14 صفر 1443
Wednesday 22nd September 2021
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Immediate post-procedural complications of percutaneous transvenous mitral commissurotomy (PTMC) with special reference to valvular and neurologic outcomes.
Tariq Mehmood Khan, Hafiz Muhammad Asif Zarif, Ammar Akhtar, Ikram Fareed Gul Zaman Khan Niazi, Muhammad Abdul Rehman Sikandar
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Volume 13 - Issue x     x - x 2021
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Objective: To assess the frequency of worsening pre-existing mitral regurgitation, development of new mitral regurgitation and the evidence of cerebral embolization in patients developing neurological deficit after the percutaneous transvenous mitral commissurotomy

Study Design: Descriptive Observational study

Place and Duration: From 1st of January 2019 to 30th of June, 2019 at Chaudhary Pervaiz Elahi Institute of Cardiology, Multan

Methodology: Patients with severe rheumatic mitral valve area of 1 cm2 planned for percutaneous transvenous mitral commissurotomy (PTMC) were included. Pre-procedural echocardiography was done to determine mitral valve area (MVA), pulmonary artery systolic pressure (PASP), trans-mitral pressure gradient (TMPG) and for presence and severity of mitral regurgitation and compared to 24 hours post-procedural echocardiography for results. Any patient complaining of any neurological deficit was evaluated clinically and CT-scan brain was also done.

Results: Among total of 142 patients included the mean age of the patients was 34.54±12.10 years and majority (55.63%) were female patients. Mitral regurgitation was diagnosed in 38.73% patients. Worsening of pre-existing mitral regurgitation on transthoracic echocardiography was noted in 16.90% patients. All patients were managed medically. New mitral regurgitation was developed in 21.83%. Only two patients (0.14%) developed neurological symptoms but were discharged without any deficit after 24 hours

Conclusion: Percutaneous Transvenous Mitral Commissurotomy for mitral stenosis is a safe procedure for severe mitral stenosis. PTMC is associated with minimal valve related and neurologic complications.

Keywords: Mitral stenosis, Percutaneous transvenous mitral commissurotomy, Mitral regurgitation, Cerebral embolization, Rheumatic heart disease, Mitral valve area