Mahbubur Rahman
Rangpur Medical College Hospital, BangladeshTitle: Procedural success and immediate results of percutaneous trans mitral commissurotomy: An experience from a tertiary care hospital in northern division of Bangladesh
Abstract
Background: One of the ultimate grave consequences of rheumatic heart disease is mitral stenosis. Percutaneous trans-mitral commissurotomy (PTMC) has been practiced with good results in the world since Inoue introduced it in 1982. But in Bangladesh, we have very little research-oriented data regarding the effectiveness and patient compliance of this procedure.
Aim of the study: The aim of this study was to audit the procedural success, and in-hospital outcome in patients undergoing percutaneous trans-mitral commissurotomy (PTMC).
Methods: This observational cross-sectional study was conducted in the northern division of Bangladesh with the collaboration of the Department of Cardiology, Rangpur Medical College Hospital, Rangpur & Zia Heart Foundation, Dinajpur during the period from February 2018 to November 2019. In total 45 patients who fulfilled the inclusion and exclusion criteria for PTMC were enrolled in this study as the study people. Among them the procedural success & immediate results were assessed. Proper written consent were taken from all the participants before starting data collection. A pre-designed questionnaire was used in patent data collection. All data were processed, analyzed and disseminated by MS Office and SPSS versions as per need.
Result: In our study in analyzing the comparative Echo Doppler data of pre & post-PTMC among the participants in both mean (±SD) MVA (cm2) and mean (±SD) MVPG (mmHg) we found an extremely statistically significant correlation between pre and post-PTMC stages where the P values were less than 0.0001. Besides these, in analyzing the pre & post-PTMC hemodynamic and procedural data of participants we observed, against LA Pressure (mmHg) (Mean ± SD), RV Pressure (mmHg) (Mean ± SD), LVEDP (mmHg) (Mean ± SD) and Transmitral PG (mmHg) (Mean ± SD) there was extremely significant correlation between pre and post PTMC stages. In all the parameters the p values were less than 0.0001.
Conclusion: We conclude that, percutaneous trans-mitral commissurotomy (PTMC) is a safe procedure in experienced hand with good success rate and optimal results even in patients with special problems like pregnancy, previous CVA and redo cases.
Keywords: Mitral stenosis (MS), Percutaneous Transmitral Commissurotomy (PTMC), immediate outcome.
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