Percutaneous Transvenous Mitral Commissurotomy in patients with rheumatic heart disease: a hospital-based retrospective study

Mohd Firdaus, Mohd Al-Baqlish and Kelvin, Shenq Woei Siew and Zainal Abidin, Muhammad 'Adil and Mohd Said, Mohd Ridzuan and Hadi, Mohd Firdaus and Abdul Hafidz, Muhammad Imran and Ismail, Muhammad Dzafir and Arjan Singh, Ramesh Singh and Wan Ahmad, Wan Azman (2022) Percutaneous Transvenous Mitral Commissurotomy in patients with rheumatic heart disease: a hospital-based retrospective study. Journal of Health and Translational Medicine (JUMMEC), 25 (2). pp. 15-18. ISSN 1823-7339 E-ISSN 2289-392X

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Abstract

Background: Percutaneous Transvenous Mitral Commissurotomy (PTMC) is a procedure of choice for the treatment of severe mitral stenosis. We aimed to describe our experiences on management of rheumatic heart disease with PTMC in Malaysia. Methods: Patients who underwent PTMC were traced through the electronic medical record of University Malaya Medical Centre. The patients detailed echocardiogram parameter pre-procedure, post-procedure and outcome were documented. Statistical analysis was performed using SPSS version on 18 for windows. Results: 11 patients were treated with PTMC in our centre with 90.9% (n=10) success rate. Subjects underwent PTMC were statistically significant associated with improved echocardiogram parameters as following: increase in mitral valve size (p=0.0058) from 0.89 ± 0.2 cm2 (pre) to 1.4 ± 0.4 cm2 (post); reduction in mean pressure gradient across mitral valve (p=0.0283) from 11.5 ± 4.9 mmHg (pre) to 6.9 ± 3.5 mmHg (post); and reduction (p=0.0019) in elevated pulmonary artery systolic pressure from 65.7 ± 21.4 mmHg (pre) to 45.6 ± 10.0 mmHg (post). More than half (62.5%, n=5) of the subjects with favourable Wilkin score 8 or less achieved good outcome defined as post-PTMC mitral valve size ≥ 1.5 cm2 . All subjects with unfavourable Wilkin score of more than 8 only achieved sub-optimal post-PTMC mitral valve size ≤ 1.5 cm2 . Conclusion: Given the minimally invasive nature of PTMC with comparable excellent haemodynamic outcome to invasive vascular repair, PTMC should be the recommended first line therapy in mitral valve stenosis.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Mitral stenosis, Mitral valve, Percutaneous Transvenous Mitral Commissurotomy, PTMC, Interventional cardiology
Subjects:	R Medicine > RC Internal medicine > RC667 Specialties of Internal Medicine-Diseases of Circulatory (Cardiovascular) System
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Community Medicine (Effective: 1st January 2011) Kulliyyah of Medicine > Department of Internal Medicine
Depositing User:	Dr Muhammad Adil Zainal Abidin
Date Deposited:	25 Nov 2022 09:37
Last Modified:	25 Nov 2022 09:37
URI:	http://irep.iium.edu.my/id/eprint/101449

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