Percutaneous Transluminal Mitral Commissurotomy in Nepalese children with Rheumatic Mitral Stenosis
Journal Title: Nepalese Heart Journal - Year 2013, Vol 10, Issue 1
Abstract
background: Rheumatic heart disease is one of the most common heart diseases in developing country; however rheumatic mitral stenosis in children is relatively rare. Percutaneous transluminal mitral commissurotomy is a well established therapeutic intervention for mitral stenosis in adults. The study is conducted to determine the effcacy and safety of PTMC in children with severe mitral stenosis. Methods: A single centre retrospective study is conducted over a 3 and half years period (from 16th November, 2009 to 15th May, 2013) in Shahid Gangalal National Heart Centre, Kathmandu, Nepal. All consecutive patients aged less than 15 years who underwent Percutaneous transluminal mitral commissurotomy for severe mitral stenosis were included. Mitral valve area, left atrial pressure and mitral regurgitation were compared pre and post procedure. Results: During the study period, 2237 patients underwent Percutaneous transluminal mitral commissurotomy. Among them 100 children less than 15 years of age were included. Successful results were obtained in 94 (94%) patients. Mitral valve area increased from 0.7±0.15 cm2 to 1.5±0.32 cm2 (p<0.001). A signifcant decrease in left atrial pressure was observed from 29±7.9 mmHg to 13.9±6.2 mmHg (p<0.001). There was no signifcant change in grade of post procedural mitral regurgitation. Conclusions: Percutaneous transluminal mitral commissurotomy in children with severe mitral `stenosis is safe, effective and should be considered as procedure of choice for childrens.
Authors and Affiliations
Manish Shrestha| Department of Pediatric Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal, Chandra Mani Adhikari| Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal, Urmila Shakya| Department of Pediatric Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal, Aayush Khanal| Department of Pediatrics, Institute of Medicine,Tribhuwan University Teaching Hospital, Kathmandu, Nepal, Shradha Shrestha| Department of Pediatric Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal, Rajib Rajbhandari| Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Rheumatic Fever and Antibody Response to Group A Streptococcal Infections
Rheumatic fever is non-suppurative sequel of group A streptococcal infection. It is a multifocal inflammatory disease, affecting primarily the heart, joints, skin and central nervous system occurring in 0.1% to 3% after...
Comment to "Amlodipine overdose with hypotension and noncardiogenic pulmonary edema"
"How I do it" Aortic Valve Replacement in case of Double Valve Replacement
Percutaneous Transluminal Mitral Commisuriotomy for Mitral Stenosis in Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Mitral stenosis (MS) is almost invariably the result of long term complication of rheumatic fever. Based upon the nature and severity of MS, patients can be managed with medical treatment, percutaneous transvenous mitr...
Surgery for Rheumatic Heart Disease in Nepal
Rheumatic heart disease is still very common in the developing world.Nepal is no exception.lack of health insurance for most people and monitoring of the PT/INR in a long run pose a signifcant fnancial challenge to an...