Effect of Subvalvular Changes on Mitral Valve Leaflets Excursion after Percutaneous Transvenous Mitral Commissurotomy.
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Date
2015
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Abstract
Background: Aim of our study was to predict the effect of subvalvular changes on mitral valve
leaflets excursion in a patient with mitral stenosis following percutaneous trans-venous mitral
commissurotomy.
Methods: Total of 60 patients of severe mitral stenosis were enrolled in the study. Transthoracic
echocardiography was done on the day before percutaneous trans-venous mitral commissurotomy
and 24-48 hours after percutaneous trans-venous mitral commissurotomy. Subvalvular area, anterior
and posterior leaflets excursion were recorded.
Results: Following percutaneous trans-venous mitral commissurotomy there were significant
increase in anterior leaflet excursion from 1.8 ± 0.2 to 2.2 ± 0.2cm (p=<0.001), posterior leaflet
excursion from 1.5±0.2to1.8 ± 0.2cm (p<0.001) . Subvalvular splitting areas was from 0.8 ± 0.2 to1.2
± 0.2cm²(p=<0.001). Pulmonary arterial systolic pressure and left atrial diameter were significantly
reduced respectively 55.6 ± 19.5 vs. 31.6 ± 9.5 mmHg,(p < 0.001) and 4.3 ± 0.6 cm vs. 3.8 ± 0.6 cm (p <
0.001). Post percutaneous trans-venous mitral commissurotomy subvalvular splitting area was
found to be the predictor of increased excursion of both anterior and posterior mitral leaflets.
Conclusion: percutaneous trans-venous mitral commissurotomy is associated with immediate
significant changes in mitral valve morphology in terms of splitting of fused mitral commissures,
increased valve leaflets excursion and splitting of the subvalvular structures. Post percutaneous
trans-venous mitral commissurotomy subvalvular splitting area was found to be the predictor of
increased excursion of both anterior and posterior mitral leaflets.
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Keywords
Mitral stenosis, Valvuloplasty, PTMC
Citation
Mannan Md. Abdul, Majumder A A S, Hossain Solaiman, Shaha Chandan Kumar, Khair Md. Abul, Ullah Mohammad, Rahman Md. Toufiqur. Effect of Subvalvular Changes on Mitral Valve Leaflets Excursion after Percutaneous Transvenous Mitral Commissurotomy. Cardiovascular Journal. 2015; 8(1): 8-12.