Document Detail

Percutaneous transvenous mitral commissurotomy: significance of echocardiographic assessment in prediction of immediate result.
MedLine Citation:
PMID:  23020539     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The current study aims to identify demographic, clinical characteristics, echocardiographic and/or mitral valve morphological parameters that may predict the successful result of percutaneous transvenous mitral commissurotomy (PTMC). 
METHODS: The medical records of 196 patients (48 males, mean age: 42.7 ± 11.5 years) who underwent PTMC were reviewed. Prior to PTMC, a combination of transthoracic and transesophageal echocardiography were used to investigate substantial mitral valve morphological subcomponents (thickening, mobility, calcification, and subvalvular thickness) and suitability for PTMC. The second transthoracic echocardiographic assessment was performed within six weeks after PTMC. Patients were divided into two categories of successful or unsuccessful according to PTMC results. Successful PTMC was defined as: final mitral valve area (MVA) ≥1.5 cm2 without a post-procedure mitral regurgitation (MR) grade >2. The significant predictor of the result was identified by comparing demographic data, initial echocardiographic assessments and mitral valve morphological scores within both groups. 
RESULTS: The mean MVA increased from 1.0 ± 0.2 cm2 to 1.7 ± 0.4 cm2, and mitral valve mean gradient (MVMG) decreased from 11.5 ± 5.2 to 5.2 ± 3.3 mmHg (P < 0.001 for both). Successful results were obtained in 139 (70.9%) patients compared to unsuccessful results in 57 (29.1%). Unsuccessful results were due to suboptimal secondary MVA < 1.5 cm2 in 50 (25.5%) patients and post-procedure MR grade >2 in 7 (3.6%). Multiple logistic regression analysis indicated that young age, lower size of the left atrium (LA), and smaller degree of mitral valve thickness were the predictors of successful result. 
CONCLUSION: Pre-procedure echocardiographic assessment appears to be helpful in predicting PTMC results. Successful PTMC is influenced by the patients' age, LA size, and mitral valve thickness.
Hakimeh Sadeghian; Mojtaba Salarifar; Mehrnaz Rezvanfard; Ebrahim Nematipour; Masoumeh Lotfi Tokaldany; Azam Safir Mardanloo; Hamid-Reza Poorhosseini; Vahid Semnani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of Iranian medicine     Volume:  15     ISSN:  1735-3947     ISO Abbreviation:  Arch Iran Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2013-02-04     Revised Date:  2013-05-15    
Medline Journal Info:
Nlm Unique ID:  100889644     Medline TA:  Arch Iran Med     Country:  Iran    
Other Details:
Languages:  eng     Pagination:  629-34     Citation Subset:  IM    
Echocardiography Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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MeSH Terms
Cardiac Catheterization
Cardiac Surgical Procedures*
Chi-Square Distribution
Logistic Models
Middle Aged
Mitral Valve / surgery,  ultrasonography
Mitral Valve Stenosis / surgery*,  ultrasonography*
Postoperative Complications / ultrasonography*
Predictive Value of Tests
ROC Curve
Retrospective Studies
Risk Factors
Treatment Outcome

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