انجام شده در بيماران تنگي دريچه ميترال PTMC بررسي نتايج كوتاه مدت 563 مورد

Early Outcomes, Complications and Hemodynamic Results of 365 Cases of Percutaneous Transseptal Mitral Commissurotomy

Mitral valvuloplasty with single Balloon or Inoue method has been used for about one decade in Iran for treatment of patients with mitral stenosis. We evaluated early outcomes, complications, and immediate hemodynamic results of 365 cases of Percutaneous Transseptal Mitral Commissurotomy (PTMC) in two academic centers from 1997 to 1999 288 cases were females (78.9%) and 77 of were male (21%). The mean age was 42 years (14-74) with a mean score of 6.2. Valvutomy was technically successful in 97.5% of the procedures and the mean mitral valve area increased from (0.99±0.46 cm2) to (1.98± 0.53cm2) and the mean trans mitral valve gradient (TMVG) decreased from (19.5±10.8 mmHg) to (2.7± 1.3 mmHg). There was no procedural death during PTMC and only one hospital death (after emergency surgery for severe MR). Major procedural complications included cardiac tamponade during septostomy in 3 cases (0.82%). Severe mitral regurgitation (MRS +3)in 4 cases (1.09%) and systemic embolization in two cases (0.59%). 12 patients had previous histories of closed mitral valve commissurotomy (CMVC) or open mitral valve comissurotomy (OMVC) (%3.2). 32% of Cases had AF rhythm before PTMC. In two cases PTMC was performed simultaneously with tricuspid vavuloplasty with the same balloon and in one case PTMC was associated with PTCA of the RCA. This study revealed that our results are similar to other studies that has been reported by other investigators using The same techniques. The Inoue technique is a safe and effective method in most patients with mitral stenosis.