A Study of Assessment of Mitral valve area before and after percutaneous balloon mitral valvuloplasty using Mitral leaflet separation index in a tertiary care center
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 7
Abstract
Background: Rheumatic fever and rheumatic heart disease continue to be endemic and leads the major acquired heart disease in India and other developing countries. The incidence of rheumatic fever and rheumatic mitral stenosis is very high in our country, having an incidence of 25-45% of the acquired heart disease, with a women to men ratio of 2:1. Percutaneous balloon mitral commissurotomy is the best mode of nonsurgical treatment offering better results in suitable valves. Mitral leaflet separation (MLS) index is one of the best method to assess the severity of mitral stenosis. The aim of this study is to assess the Mitral valve area before and after percutaneous balloon mitral valvuloplasty using Mitral leaflet separation index in a tertiary care center Methods: A retrospective study was done in the Institute of Cardiology, Madras Medical College, Chennai, Tamil nadu. Fifty patients with rheumatic mitral stenosis who underwent Percutaneous balloon mitral commissurotomy were evaluated clinically and echocardiographically during and after the procedure. In all patients the Mitral valve stenosis severity was assessed using mitral valve area in 2D echo by planimetry, pressure half time and mitral leaflet separation index. The mitral leaflet separation index (MLS) was estimated by measuring average of distance between the maximal separation of tip of mitral valve leaflets in end-diastole in parasternal long axis and four chamber echocardiographic views. Results: In our study, the mean age of the population was 20.51 ± 10.22 years and included mostly female gender (83%). The mitral valve area measured after Balloon valvotomy increased from 0.80 ± 0.13 cm2 to 1.65 ± 0.36 cm2 as measured by echocardiography. Pre procedure PTMC the mean MVA (PHT) was 0.80 ± 0.25 cm2 and MLS index was 5.75 to 6.25 mm. and after the procedure (PTMC) the mean MVA (PHT) was 1.65 ± 0.36 cm2 and Mitral leaflet separation index (MLSI) was 10.22 to 15.55 mm. In our study we noted, better correlation between the measured mitral valve area by echocardiography and mitral leaflet separation index (MLSI) (r = 0.36, p= 0.0132) and also between MVA (PHT) and mitral leaflet separation index (MLSI) (r = 0.54, p = 0.0001). Conclusion: By using simple non invasive, easily available echocardiography method, the mitral leaflet separation index (MLSI) we can assess the severity of mitral stenosis before and after Percutaneous balloon mitral commissurotomy (PTMC).
Authors and Affiliations
Dr Ravishankar Govindarajulu
Keywords
Related Articles
- EP ID EP517509
- DOI -
- Views 64
- Downloads 0
MRCP and Its Role in the Evaluation of Pancreaticobiliary Tract in Gall Stone Disease at a Tertiary Care Centre in North India
MRCP (Magnetic Resonance Cholangio Pancreatography) is a widely used investigation and is now firmly established in the evaluation of the biliary and pancreatic ducts. It helps in the assessment of causes of biliary abno...
External Validation of PCOS Questionnaire in Assessing Quality of Life in Females with PCOS Based on Lifestyle Changes with Therapeutic Measures like OC Pills and Metformin
Abstract Background: The aim was to study the effect of metformin in a lifestyle modification program combined with oral contraceptive pills on quality of life parameters measured by PCOS questionnaire in women and valid...
Results of Spinal Fixation in Thoracolumbar Spine fractures with Spinal Cord Injury using the ASIA Impairement Scale
Spinal fixation provides stability to the vertebral column but the treatment of unstable fractures of thoracolumbar spine has long been controversial. Probably the best way is to understand that Vertebral column disrupti...
Perception and attitude of medical students towards their career choices and speciality of Psychiatry
Background: To evaluate students’ perception and attitude towards psychiatry in comparison with other specialities like medicine, surgery, paediatrics, obstetrics & gynaecology, orthopaedics, radio diagnosis and dermatol...
Malignant Phyllodes Tumor Mimicking Metaplastic Carcinoma of Breast- A Case Report
In this article we are presenting a case of a 36 year old female with gradually progressive left breast mass who underwent mastectomy surgical procedure and on histopathological examination a diagnosis of malignant phyll...