EFFECT OF PERCUTANEOUS TRANSVENOUS MITRAL COMMISUROTOMY (PTMC) ON RIGHT VENTRICULAR FUNCTION

Abstract

Objectives: Rheumatic heart disease causes significant morbidity and mortality among the cardiovascular diseases. Mitral stenosis (MS) is the commonest of all rheumatic heart disease. MVR was the definitive treatment for symptomatic mitral stenosis. But after the introduction of percutaneous transvenous mitral valve commissurotomy (PTMC), it is emerged as a safe and effective procedure for the treatment of symptomatic mitral stenosis. To determine the pre and post changes in right ventricular function among patients subjected to percutaneous mitral valve commissurotomy for mitral stenosis.

Methodology: This Quasi experimental study was conducted in the Department of Cardiology Hayatabad Medical Complex Peshawar from April, 2021-Oct, 2021. TTE was performed at baseline and PTMC was done in all patients. After PTMC, all patients were kept in CCU for next 24 hours and another TTE was performed at 24th hour after PTMC for measuring changes in the RV function in terms of RVSP, RVOT-FS, RV TEi index, RV wall thickness, pulmonary artery systolic pressure.

Results: As per changes in RV parameters before PTMC and 24 hours PTMC, mean and SDs for RVSAP was 5.70+4.50 with P Value 0.000. Mean and SDs for RVOT-FS was -1.22+3.02 with P Value 0.003. Mean and SDs for RV ETi index was 0.14+0.015 with P Value 0.000. Mean and SDs for RV wall thickness was 0.10+0.03 with P Value 0.000.  Mean and SDs for pulmonary artery systolic pressure 17.099+4.20 with P Value 0.000.

Conclusion: PTMC has significant effect on pre and post changes in right ventricular function amongst patients subjected to percutaneous mitral valve commissurotomy for mitral stenosis.