Study of Percutaneous transvenous mitral commissurotomy outcomes in valves with different Echocardiographic features

R. Rajbhandari, R. Tamrakar, J. Shah, Arya Pradhan, Sarbagya Manandhar, Utsav Dangol, Rebika Dangol
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Abstract

BACKGROUND Percutaneous transvenous mitral commissurotomy (PTMC) is now a standard treatment for suitable mitral stenosis. However all procedures are not always successful or optimal. Despite having so much experience on the procedure the prediction as which types of valves give good results after PTMC is not very much defined. METHODS Initial sixty patients of PTMC of Shahid Gangalal hospital (18 male, 42 female), age ranging from 13 to 65 years, mean age 29.9±11.5 years, were studied retrospectively. Their echocardiography data before and after balloon dilatation of mitral valve were collected. The appearance of mitral valve on echocardiogram before PTMC was scored for leaflet thickening, leaflet mobility, subvalvular thickening and calcification. They were categorized into low scoring group A if they scored 8 or low, and high scoring group B if they scored above 8 according to Wilkins score. RESULTS Results were classified as successful and optimal (if valve area > 1.5cm2) or suboptimal (if valve area ≤1.5 cm2). High scoring leaflet deformity with more than 8 was associated with suboptimal results while low score group had successful outcomes and their difference was significant statistically. CONCLUSION Patients with high severity scoring of mitral valve disease had poor outcome in comparison to those with low score.
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不同超声心动图特征瓣膜经皮经静脉二尖瓣合拢切开术的疗效研究
背景:经皮经静脉二尖瓣合并术(PTMC)是目前治疗二尖瓣狭窄的标准方法。然而,并非所有的手术都是成功的或最佳的。尽管在这个过程中有这么多的经验,但预测哪种类型的阀门在PTMC后会产生良好的效果并不是很明确。方法回顾性分析沙希德医院收治的60例PTMC患者,其中男18例,女42例,年龄13 ~ 65岁,平均29.9±11.5岁。收集二尖瓣球囊扩张术前后的超声心动图资料。对PTMC前二尖瓣超声心动图表现进行小叶增厚、小叶活动性、瓣下增厚和钙化评分。根据威尔金斯分数,如果得分为8分或更低,就分为A组低分,如果得分在8分以上,就分为B组高分。结果将结果分为成功和最优(瓣膜面积> 1.5cm2)和次优(瓣膜面积≤1.5 cm2)。评分高于8分的小叶畸形评分高组预后不佳,评分低组预后良好,差异有统计学意义。结论二尖瓣疾病严重程度评分高的患者预后较低。
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