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

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 e...

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Main Authors: Mohd Firdaus, Mohd Al-Baqlish, Kelvin, Shenq Woei Siew, Zainal Abidin, Muhammad 'Adil, Mohd Said, Mohd Ridzuan, Hadi, Mohd Firdaus, Abdul Hafidz, Muhammad Imran, Ismail, Muhammad Dzafir, Arjan Singh, Ramesh Singh, Wan Ahmad, Wan Azman
Format: Article
Language:en
Published: Faculty of Medicine, Universiti Malaya 2022
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Online Access:http://irep.iium.edu.my/101449/1/101449_Percutaneous%20Transvenous%20Mitral%20Commissurotomy.pdf
http://irep.iium.edu.my/101449/
https://jupidi.um.edu.my/index.php/jummec/article/view/30224/14311
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Summary: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.