Ajaz Ahmad, Shahid Imran, Nadeem Hayat Mallick.
Percutaneous transvenous mitral commissurotomy; outcome of in patients of mitral stenosis.
Professional Med J Jan ;14(4):602-9.

Objective: To compare the clinical, echocardiographic and angiographic variables after PTMC in patients of mitral stenosis having echo score < 8 and 2.8. Place of study: Cardiology ward and echocardiography department of the Punjab Institute of Cardiology, Lahore. Duration of study: The study was conducted from 15th of January 2006 till 30th of July 2006. Study Design: It was a comparative study. Materials & Methods Two hundred consecutive patients of mitral stenosis undergoing PTMC were studied. Patients were divided in to two groups. Group I consisted of patient having echo score <8, while Group Il contained patients having echo score >=8. Results:The immediate clinical follow-up of 200 patients who underwent PTMC procedure was studied. Patients were divided into 2 groups, Echo-Sc <8 (n=136) and Echo-Sc >= 8 (n=64). PTMC resulted in an increase in mitral valve area from 1.0±0.3 to 2.0±0.6 cm2 in patients with Echo-Sc<8 and from 0.8±0.3 to 1.6±0.6 cm2 in patients with EchoSc >= 8 (P<0.0001). Procedural su ccess was 83.5% for the overall group, with patients with Echo-Sc <8 having a higher procedural success (93.4% versus 62.5%; P<0.0001). Thirty three (16.5%) patients had unsuccessful procedures. There was 1(0.5%) in-hospital death. Severe post- PTMC MR (>= 3 grade) occurred in 19(9.4%) patients, with grade IIl in 12 (6%) and grade lV in 7(3.5%). Emergent MVR was required in 3(1.5%) of 200 patients. Pericardial tamponade occurred in 2(1%) patients. Thromboembolic events (stroke) occurred in 2(1%) patients in the overall population. Finally 1(0.5%) patient developed complete atrioventricular block. Conclusions: Patients with echo score less than 8 have a favourable outcome in terms of procedural success and post procedure complications as compared to patients with echo score >=8.

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