Immediate impact of percutaneous transvenous mitral commissurotomy on right ventricular function
Journal Title: Nepalese Heart Journal - Year 2017, Vol 14, Issue 2
Abstract
Background and Aims: Abnormal Right Ventricular (RV) function affects the long term outcome and clinical symptoms in patients with mitral stenosis (MS). This study evaluates the immediate effect of Percutaneous Transmitral Commisurotomy (PTMC) on RV function. Methods: An observational, cross sectional study was done on 50 patients with rheumatic MS who underwent PTMC at Shahid Gangalal National Heart Center from Dec 2015 –Dec 2016. All underwent clinical evaluation and echocardiogram before and immediately after PTMC. Results: There was female preponderance with 66% being female. The mean age was 37.26 ± 10.63 years. There was immediate increase in the mitral valve area (MVA) from 0.87 ± 0.12cm2 to 1.54 ± 0.27cm2(p< 0.001). There was signifcant decrease in mean mitral diastolic gradient from 16.4 ± 8.8mmHg to 5 ± 1.5mmHg (p< 0.001), in the pulmonary artery systolic pressure 53.6 ± 21.83mmHg to 39.5 ± 14.67mmHg (p< 0.001), in the RV Tei index from 0.56 ± 0.08 to 0.40 ± 0.08 (p< 0.001). There was signifcant increase in TAPSE from 16.0 ± 1.50 to 18.6 ± 1.70 mm, (p<0.001) and the longitudinal velocity of excursion of the RV at the tricuspid annulus (RV S’) from 13.69 ± 3.33 cm/sec to 15.31 ± 3.07 cm/sec (p< 0.001) Conclusions: Successful PTMC can improve RV function as shown by the improvement in PASP, RV Tei index, TAPSE and RV S’. Further larger population studies are required to confrm the fndings. Long term studies are important to determine the prognostic signifcance of improvement in RV function.
Authors and Affiliations
Bishal KC| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Rabi Malla| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Ram Kishore Shah| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Anish Hirachan| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Binay Kumar Rauniyar| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Deepak Limbu| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Milan Gautam| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Amit Kumar Agrawal| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Miqdaadh Shareef| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Arun Maskey| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Man Bahadur KC| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Chandra Mani Adhikari| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Rajib Rajbhandari| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal, Deewaker Sharma| Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal
Keywords
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- EP ID EP15787
- DOI http://dx.doi.org/10.3126/njh.v14i2.18498
- Views 387
- Downloads 19
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