Evaluation of the pulmonary artery pressure during Percutaneous Transvenous Mitral Commissurotomy in Rheumatic Mitral Stenosis

While many literatures reviewed till dates have shown that It takes 3-6 months time period for the reduction of pulmonary artery pressure after PTMC. This study is designed to see pulmonary artery pressure immediately after procedure.

 

Method:

All the patients with Rheumatic Mitral Stenosis in Cath Lab under department of cardiology of Chitwan Medical College from October 1 2018 to August 30 2019 were included in this study

 

Results:

It is a prospective observational study on a total of 42 patients who underwent PTMC, 30 were female and 12 were male. Age ranged from 30 to 61 years with the mean age of 45.36±10 years. The mean mitral valve area increased from 0.87±0.2 cm2 to 1.74±0.17 cm2 whereas Mean Pressure Gradient decreased from 13.59± 7.30 to 5.15±30 as. Mean Pulmonary Artery Pressure decreased from 41.50 ±16.00 to 33.50±12.00. Similarly, the mean left atrial pressure decreased from 26.57±8.62 mmHg to 15.50±5.95 mmhg whereas, the mean Aortic Pressure increased from 91.43 ±23.02 mmHG  to  98.29±24.92 mmHg as assessed by right heart catheterization. Eighteen (42.85%) patients had an increase in MR by 2 grades but there is no need of immediate mitral valve replacement. During procedure, paroxysmal PSVT was noted in six (14.285%) patients and also local hematoma was observed in five (11.90%) patients.

 

Conclusion:

There is reduction of pulmonary artery pressure immediately post PTMC which is directly correlated with left atrial pressure without significant MR and tachycardia.