EFFICACY AND IMMEDIATE OUTCOMES OF PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN SEVERE RHEUMATIC MITRAL STENOSIS

Abstract

Objectives: To assess the frequency of successful Percutaneous Balloon Mitral Valvuloplasty (PBMV) and immediate post-procedure outcomes in patients with severe rheumatic mitral stenosis (SRMS).

Methodology: This descriptive cross-sectional study was conducted at the Department of Cardiology at a tertiary care hospital, from 1^st January 2018 to 31^st December 2019. According to inclusion criteria, 200 patients with severe symptomatic mitral stenosis (SSMS) were recruited in the study, and written informed permission was acquired from patients or next of kin. Pre- and post-PBMV mitral valve area (MVA) and hemodynamics were recorded. Data were retrieved from the hospital chart record and collected on a pre-designed proforma.

Results: In 176 (88%, n=200) patients mean MVA following PBMV increased from 0.93±0.31 cm2 to 1.73±0.16 cm² (p ˂0.05) and mean pulmonary artery systolic pressure (PASP) reduced from 56.62 mmHg ± 16.02 to 30.37±7.30 mmHg (p<0.05). Perioperative complications included severe mitral regurgitation (MR) in 2 (1%, n=200), moderate MR in 40 (20%, n=200), thromboembolic cerebrovascular accident in 1 (0.5%, n=200), pericardial effusion in 4 (2%, n=200), and new-onset atrial fibrillation in11 (5.5%, n=200), however, there was no mortality related to the procedure.

Conclusion: PBMV was effective with reasonable immediate post-procedure outcomes in 88% of patients. However, efficacy can be increased by selecting patients with favourable valve morphology for PBMV.