Lubna Baqai, Shazia, Naveen Nasim, Erum Baloch, Sumyia Gurmani, Kubra Khaliq.
Tricupsid valve involvement in chronic rheumatic mitral stenosis: an observational study..
Professional Med J Jan ;28(09):1315-21.

Objective: The aim of this study was to assess the incidence of tricuspid valve involvement in rheumatic mitral stenosis among Pakistani patients that helps in the medical decisions and special consideration for the management of disease. Study Design: Prospective Study. Setting: National Institute of Cardiovascular Disease (NICVD), Karachi. Period: February 2018 to November 2019. Material & Methods: As per the study inclusion criteria, Three fifty eight (358) Pakistani patients' diagnosed with Rheumatic Mitral stenosis. The study was compiled as per international standards (ICH-GCP-E6), prior to initiation, the ethics review committee approved the study and informed consent was taken from all recruited subjects. Results: The study prospectively assessed the echocardiographic profile of rheumatic heart disease patients and recruited 358 patients with chronic Rheumatic Mitral Stenosis. Out of these patients, 93.9% (336) had tricuspid regurgitation and 7% (25) had triscuspid stenosis. Their ages ranged from 14 to 85 years (mean 40.3 years). Of these, 73.6% (263) were females and 26.5% (95) were males. On the basis of severity, in case of  tricuspid stenosis, 3.9% (14) were mild, 1.1% (4) were moderate and 2% (7) were progress from mild to moderate. In case of  Tricuspid regurgitation, 39.9% (143) were mild, 29% (105) moderate and 88% (24.6) were severe. Conclusion: The study concluded that in the local population, the patients with chronic Rheumatic Mitral Stenosis had common involvement of Triscuspid valvular disease, more come in female and affected all age groups. Hence, before management of Rheumatic Mitral Stenosis with other lesions, especially the Triscuspid valve involvement, detailed assessment is required in order to achieve the best outcome in patients with the Mitral valve disease.

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