క్లినికల్ & ప్రయోగాత్మక కార్డియాలజీ
అందరికి ప్రవేశం

నైరూప్య

Evaluation of the Patients with Severe LV Systolic Dysfunction and Mitral Valve Stenosis after Percutaneous Transvenous Mitral Commissurotomy

Ata Firouzi, Aisha Siraj, Mohammad Javad Alemzadeh-Ansari, Ebrahim Ghobadi Fard, Hamidreza Sanati, Bahram Mohebbi, Zahra Alizdeh Sani, Armin Bordbar, Moslem Shadmani, Hooman Bakhshandeh, Behshid ghadrdoost and Negar Saleh

Introduction: A valid alternative to surgical therapy in selected patients with mitral stenosis is percutaneous transvenous mitral commissurotomy (PTMC).There is an increase in preload and severe heart failure in patients with severe LV dysfunction and severe mitral stenosis (MS) after PTMC. In the present study, we evaluate the patients with MS who underwent PTMC aimed at dyspnea and pulmonary hypertension.
Method: In this cross-sectional study, 20 patients with severe LV systolic dysfunction (LVEF less than 35%) and severe MS (MVA<1.5 cm2) who underwent PTMC between March-2009 and March-2015 were enrolled. TTE was performed a day before, one day, and six months after PTMC. Mitral valve area (MVA) and systolic pulmonary atrial pressure (SPAP) before and after the procedure were compared.
Result: Eleven (55%) patients were female (mean age: 46.0 ± 13.09). All patients underwent successful PTMC without any complications. The systolic PAP decreases significantly from 61.25 ± 9.15 mmHg at baseline to 36.75 ± 3.72 mmHg one day after procedure (p<0.0001), also it reached to 34.5 ± 3.2 mmHg 6 month after PTMC. The Mitral valve area (MVA) increased from 0.76 ± 0.14 cm2 at baseline to 1.26 ± 0.17 cm2 one day later. Also, NYHA Functional class in the majority of patients significantly improved.
Conclusion: Mitral valve area and pulmonary artery pressures appeared to influence the outcome of PTMC. Despite the increased preload in patients with severe systolic LV dysfunction, dyspnea recovered, and FC and SPAP were significantly reduced after six months of performing PTMC.