Tariq Mehmood Khan, Hafiz Muhammad Asif Zarif, Ammar Akhtar, Ikram Fareed Gul Zaman Khan Niazi, Muhammad Abdul Rehman Sikandar

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ABSTRACT

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 1^st of January 2019 to 30^th 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