Percutaneous transmitral balloon commissurotomy (PTMC): Procedural success and immediate results at Ahmed Gasim Cardiac Center

Abstract

Background: Balloon valvuloplasty for stenosed mitral and pulmonary valves has been practiced with good results for the last two years in Ahmed Gasim Cardiac Centre, Khartoum Sudan.
Objectives: The aim of this study is to audit percutaneous trans-mitral balloon commissurotomy [PTMC] in our current set up.
Methods: One hundred and eight patients underwent percutaneous transvenous mitral commissurotomy (PTMC) from April- 2004 to December-2005 in Ahmed Gasim cardiac center.
Results: 67% percent of the patients were females. Age range was from 13years to 65years and the mean age was 27years. 27% were under 21 years of age and 12% had special problems. The procedural success was achieved in 94.5% patients, in two patients we failed to dilate a tough septum, in other two the balloon got stuck to the septum and failed to cross the MV, while two patients had successful emergency MVR (due to inadvertent puncture of the RA and cardiac tamponade). There was no mortality related to the procedure, significant mitral regurgitation of > grade 2 didn't occur. No patient developed systemic embolization. Optimal results were achieved in 91.6% patients and in 92% of the patients with special problems. Hemodynamic data in the Cath. Lab showed left atrial mean (±SD) pressure dropped from 32 (±3.2) mmHg to 12 (±2.4) mmHg. LA-LV gradient dropped from an average of 25 to 5 mmHg. Echocardiographic assessment showed mean (±SD) mitral valve area increased from 0.86 (±0.19) cm² to 1.9 (±0.5) cm² (p<0.001) and PA pressure dropped from71 (±23) to 40 (±12) mmHg (p<0.01).
Conclusion: We conclude that PTMC is a safe procedure with good success rate and optimal results even in patients with special problems like redo and previous CVA.

Sudan Journal of Medical Science Vol. 1 (2) December 2006: 115-120