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Mid-term results of percutaneous transmitral commissurotomy (PTMC) in central iran | ||
| Cardiovascular Biomedicine | ||
| Volume 4, Issue 1, August 2024, Pages 1-9 PDF (775.01 K) | ||
| Document Type: original articles | ||
| DOI: 10.18502/cbj.v4i1.16221 | ||
| Authors | ||
| Abbas Andishmand1; Hossein Montazer Ghaem* 2; Somayeh Fallahzadeh3; Mojtaba Andishmand1; Hasan Haghaninejad1; Faezeh Dehghani Tafti1; Seyedeh Mahdieh Namayandeh1; Hossein Nough1 | ||
| 1Yazd Cardiovascular Research Center, Non- communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| 2Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran | ||
| 3khatamolanbia Hospital, Abarkooh University of Medical Sciences,Yazd, Iran | ||
| Abstract | ||
| Objectives: Percutaneous Trans-Mitral Commissurotomy (PTMC) is an effective non-surgical treatment in patients with severe rheumatic mitral valve stenosis. This study aimed to evaluate the mid-term results of this procedure in central Iran. Methods: This retrospective study was performed on 101 patients with severe mitral valve stenosis who underwent successful PTMC from March 2011 to September 2018 in Afshar Hospital in Yazd. At follow-up, all patients underwent clinical examination, two-dimensional and color Doppler echocardiography, and events were recorded. Data were analyzed using SPSS software version 19. Results: The mean age of the patients was 44.79± 11.72 years, and 83.3% were female. The mean follow-up time was 38.98 23.33 months (6-94 months).25.8% had AF rhythm, and 12% had previous PTMC or OMVC or CMVC. After percutaneous Trans-Mitral Commissurotomy, 97% of patients were in NYHA functional class I, II and the mitral valve area (MVA) increased from 0.92 ± 0.18 to 1.66± 0.29 cm2 (p<0.0001). Pulmonary artery systolic pressure decreased from 46.96± 18.56 mmHg to 38.43±14.02 mmHg (p<0.0001). The Mean mitral valve gradient decreased from 12.37± 3.99 mmHg to 4.79± 2.38 mmHg (p<0.0001). Restenosis rate and severe mitral regurgitation resulting in mitral valve replacement (MVR) were 10.9% and 2%, respectively. Two patients died because of intracranial hemorrhage (ICH). During the follow-up event, free survival was 82.2%. Multivariable analysis revealed that the predictors of shorter event-free survival were AF rhythm (HR; 4.5, 95%CI;1.59-12.9, P=0.005) and post PTMC higher NYHA functional class (HR;2.2, CI;1-4.8,p=0.049). Conclusions: Mid-term results of percutaneous transmitral commissurotomy (PTMC) in central Iran are the same as in other parts of the world. This procedure is an effective and low-risk treatment for severe mitral valve stenosis. | ||
| Keywords | ||
| Survival; Rheumatic fever; mitral valve stenosis; percutaneous trans-mitral commissurotomy | ||
| References | ||
|
1.Seckeler MD, Hoke TR.The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol.2011; 3:67-84.
2.Watkins DA, Johnson CO, Colquhoun SM, et al. Global, Regional, and National Burden of Rheumatic Heart Disease, 1990-2015. N Engl J Med. 2017; 377(8):713-722.
3.Qazizadeh Z, Shahmoradi L, Moosazadeh M, et al. Prevalence of Rheumatic Heart Disease in Iran: A Systematic Review and Meta-Analysis. J Pediatr Rev. 2021; 9(2):97-104.
4.Sticchi A. Mitral valve stenosis: epidemiology and causes in elderly patients.J Cardiol.2018; 16:14.
5.Carabello BA. Modern management of mitral stenosis. Circulation.2005;112(3):432-7.
6.Ben Farhat M, Ayari M, Maatouk F, et al. Percutaneous balloon versus surgical closed and open mitral commissurotomy:seven-year follow-up results of a randomized trial. Circulation. 1998; 97(3):245–250.
7.Turi ZG, Reyes VP, Raju BS, et al. Percutaneous balloon versus surgical closed commissurotomy for mitral stenosis. A prospective,randomized trial. Circulation. 1991; 83(4):1179-85.
8.Reyes VP, Raju BS, Wynne J, et al. Percutaneous balloon valvuloplasty compared with open surgical commissurotomy for mitral stenosis. N Engl J Med. 1994;331(15): 961-7.
9.Wilkins GT, Weyman AE, Abascal VM, et al. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J. 1988; 60(4):299–308.
10.Hildick-Smith DJ,Taylor GJ, Shapiro LM. Inoue balloon mitral valvuloplasty: long-term clinical and echocardiographic follow-up of a predominantly unfavourable population. Eur Heart J. 2000; 21(20):1690-7.
11.Dean LS, Mickel M, Bonan R, et al. Four-year follow-up of patients undergoing percutaneous balloon mitral commissurotomy.A report from the National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry. J Am Coll Cardiol. 1996; 28(6):1452-7.
12.Cohen DJ, Kuntz RE, Gordon SP, et al. Predictors of long-term outcome after percutaneous balloon mitral valvuloplasty. N Engl J Med. 1992; 327(19):1329-35.
13.Palacios IF, Sanchez PL, Harrell LC, et al. Which patients benefit from percutaneous mitral balloon valvuloplasty? Prevalvuloplasty and postvalvuloplasty variables predict long-term outcome.Circulation. 2002; 105(12):1465–1471.
14.Song JK, Kim MJ, Yun SC, et al. Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery.J Thorac Cardiovasc Surg.2010;139 (1):103-10.
15.Palacios IF, Block PC, Wilkins GT, et al.Follow-up of patients undergoing percutaneous mitral balloon valvotomy.Analysis of factors determining restenosis. Circulation. 1989; 79(3):573-9.
16.Wang A, Krasuski RA, Warner JJ, et al. Serial echocardiographic evaluation of restenosis after successful percutaneous mitral commissurotomy. J Am Coll Cardiol. 2002;39(2):328-34.
17.Hernandez R, Banuelos C, Alfonso F, et al. Long-term clinical and echocardiographic follow-up after percutaneous mitral valvuloplasty with the Inoue balloon. Circulation. 1999;99(12): 1580–1586.
18.Tsuji T, Ikari Y, Tamura T, et al. Pathologic analysis of restenosis following percutaneous transluminal mitral commissurotomy.Catheter Cardiovasc Interv. 2002; 57(2): 205-10.
19.Arora R, Kalra GS, Singh S, et al. Percutaneous transvenous mitral commissurotomy: Immediate and long‐term follow‐up results.Catheter Cardiovasc Interv. 2002;55(4):450-456.
20.Kaul UA, Singh S, Kalra GS, et al. Mitral regurgitation following percutaneous transvenous mitral commissurotomy: a single-center experience. J Heart Valve Dis. 2000; 9(2):262-6; discussion266-8.
21.Koren O, Israeli A, Rozner E, et al. Clinical and echocardiographic trends in percutaneous balloon mitral valvuloplasty. J Cardiothorac Surg. 2021; 16(1):68.
22.Mohan JC, Chutani SK, Sethi KK, et al. Determinants of left ventricular function in isolated rheumatic mitral stenosis. Indian Heart J. 1990; 42(3):175-9.
23.Chen CR, Cheng TO. Percutaneous balloon mitral valvuloplasty by the Inoue technique: a multicenter study of 4832 patients in China. Am Heart J. 1995;129(6): 1197-203.
24.Miura S, Arita T, Domei T, et al. Impact of preprocedural atrial fibrillation on immediate and long-term outcomes after successful percutaneous mitral valvuloplasty of significant mitral stenosis. Cardiovasc Interv Ther. 2018; 33(1): 46–54.
25.Inoue K, Owaki T, Nakamura T, et al. Clinical Application of Transvenous Mitral Commissurotomy by a New Balloon Catheter. J Thorac Cardiovascular Surg.1984;87 (3):394-402. | ||
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