An Observational study to assess Immediate hemodynamic outcomes in patients undergoing percutaneous Transvenous mitral commissurotomy in Our Institution

Arthi, A (2017) An Observational study to assess Immediate hemodynamic outcomes in patients undergoing percutaneous Transvenous mitral commissurotomy in Our Institution. Masters thesis, Madras Medical College, Chennai.


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BACKGROUND AND OBJECTIVES: Several studies conducted on the prevalence of rheumatic heart disease reported a prevalence of 34.54/1000 in India. Furthermore, demands for adequate medical therapies are expanding with increasing use of Percutaneous transvenous mitral valvuloplasty. In comparison to the surgical mitral commissurotomy Percutaneous mitral valvotomy has shown better success rates, comparable restenosis rates, larger valve area and long term durability. The most widely used echocardiographic parameter for patient selection for PTMC, is the Wilkins score which we follow in our institute. Our study aims to analyse the immediate hemodynamic outcomes in patients undergoing Percutaneous mitral valvotomy in our institute selected by specific clinical and echo criteria. METHODS: In this following hospital based observational study, fifty patients who were admitted as inpatients for the above procedure in the department of cardiology, who met the inclusion and exclusion cirteria were followed up during intraoperative and postoperative period. Immediate functional outcome of the procedure in terms of hemodynamic improvement was assessed by measuring the percentage of improvement in mitral valve orifice area, Left atrial pressure and mitral valve peak gradient. RESULTS: Out of the 50 patients who were included in the study group 64% were in 21-40 age group, 78% were females, 52% have symptoms and NYHA II, 48% have symptoms in NYHA class III, 0% in NYHA class I & IV. All the patients had wilkins score of 8 or below. 84% Patients had no atrial fibrillation. Even though lower age group, female sex, no atrial fibrillation and lower NYHA class seemed to have better outcomes the association was not statistically significant. The association between wilkins score and outcome with regard to all three parameters was statistically significant. CONCLUSION: PTMC is the procedure of choice for the management of uncomplicated and pliable mitral stenosis. Even though Echocardiographic scores are not the only parameters determining the outcome of PTMC, they still have a significant role in patient selection for PTMC.

Item Type: Thesis (Masters)
Additional Information: Reg.No.201411003
Uncontrolled Keywords: Percutaneous transvenous mitral commisurotomy, rheumatic heart disease, mitral stenosis, Wilkins score, outcomes, echocardiography.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 23 Feb 2020 10:15
Last Modified: 23 Feb 2020 10:15

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