LONG TERM ECHOCARDIOGRAPHIC FOLLOW UP OF PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY (PTMC)

Objective: This study was conducted to report the local experience of long-term echocardiographic follow up of Percutaneous Transvenous Mitral Commissurotomy in symptomatic severe mitral stenosis (MS) patients.Material and Methods: We conducted this retrospective computer data base echocardiographic study of symptomatic severe MS patients (who underwent PTMC from 1992 to 1995 in our cardiology unit) to evaluate the immediate and long term echocardiographic results of PTMC in 269 patients. We did transthorasic and Transoesophageal echocardiographic study of all symptomatic severe Mitral stenosis patients. Those patients who were found eligible and underwent PTMC were selected for the study. Total of 269 patients were evaluated.Results: Female constituted 67.7% and Male were 32.3% of total patient population. The mean age of patients was 27.51+/- 7.82 years. Mean Mitral valve area on day one increased from< 1.0cm2 to > 1.5cm2 in 72.9% of patients. At four years the mean area was 1.4cm2+/-0.10(p=NS). Peak and mean Mitral valve gradients increased from 10.07mmHg +/-4.59 at day one to 14.57mmHg+/-6.66 at four year( p=NS). Mean MVG was 6.31+/-3.50mmHg on day one and 10.29+/-5.62 at four years(p=NS). Mean right ventricular systolic pressure post PTMC was 46.35+/-14.35mmHg and decreased to 13.50+/-30.37 mmHg (p=0.120) at four years. The RV size was found to decrease from 2.16+/- 0.48cm to 1.7+/-0.45cm at four years (p=NS). The LA size did not change much (from 4.15+/-0.59 cm to 4.24+/ -0.43, p=NS) Very few patients (2.2%) developed significant restenosis (MVA < 1.0cm2).Conclusion: The study shows that PTMC is an effective and safe method to relieve MS and it improves the haemodynamics and the results are sustained over prolonged period.