Mid-term (up to 12 years) clinical and echocardiographic outcomes of percutaneous transvenous mitral commissurotomy in patients with rheumatic mitral stenosis

Autor: Maryam Moshkani Farahani, Alireza Moaref, Mohsen Sadeghi Ghahrodi, Yahya Dadjo, Reza Nowshad, Javad Kojuri
Rok vydání: 2020
Předmět:
Adult
Balloon Valvuloplasty
Male
medicine.medical_specialty
Cardiac Catheterization
Time Factors
Heart disease
medicine.medical_treatment
030204 cardiovascular system & hematology
Iran
Severity of Illness Index
Mid-term outcome
03 medical and health sciences
0302 clinical medicine
Mitral valve stenosis
Adverse cardiac events
Predictive Value of Tests
Recurrence
Mitral valve
Internal medicine
medicine
Diseases of the circulatory (Cardiovascular) system
Humans
Mitral Valve Stenosis
030212 general & internal medicine
Antibiotic prophylaxis
Retrospective Studies
Restenosis
business.industry
Mitral valve replacement
Rheumatic Heart Disease
Retrospective cohort study
Percutaneous transvenous mitral commissurotomy
Recovery of Function
Middle Aged
medicine.disease
Progression-Free Survival
Cardiac surgery
Echocardiography
Doppler
Color
Stenosis
medicine.anatomical_structure
RC666-701
Cardiology
Mitral Valve
Female
Cardiology and Cardiovascular Medicine
business
Echocardiography
Transesophageal
Research Article
Zdroj: BMC Cardiovascular Disorders
BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-10 (2021)
ISSN: 1471-2261
Popis: Background Rheumatic heart disease (RHD) is still a concerning issue in developing countries. Among delayed RHD presentations, rheumatic mitral valve stenosis (MS) remains a prevalent finding. Percutaneous transvenous mitral commissurotomy (PTMC) is the intervention of choice for severe mitral stenosis (MS). We aimed to assess the mid-term outcome of PTMC in patients with immediate success. Methods In this retrospective cohort study, out of 220 patients who had undergone successful PTMC between 2006 and 2018, the clinical course of 186 patients could be successfully followed. Cardiac-related death, undergoing a second PTMC or mitral valve replacement (MVR) were considered adverse cardiac events for the purpose of this study. In order to find significant factors related to adverse cardiac outcomes, peri-procedural data for the studied patients were collected.The patients were also contacted to find out their current clinical status and whether they had continued secondary antibiotic prophylaxis regimen or not. Those who had not suffered from the adverse cardiac events were additionally asked to undergo echocardiographic imaging, in order to assess the prevalence of mitral valve restenosis, defined as mitral valve area (MVA) 2 and loss of ≥ 50% of initial area gain. Results During the mean follow-up time of 5.69 ± 3.24 years, 31 patients (16.6% of patients) had suffered from adverse cardiac events. Atrial fibrillation rhythm (p = 0.003, HR = 3.659), Wilkins echocardiographic score > 8 (p = 0.028, HR = 2.320) and higher pre-procedural systolic pulmonary arterial pressure (p = 0.021, HR = 1.031) were three independent predictors of adverse events and immediate post-PTMC mitral valve area (IMVA) ≥ 2 cm2 (p 2 (p = 0.001, OR = 0.240). Conclusion The mid-term results of PTMC are multifactorial and may be influenced by heterogeneous peri-procedural determinants. IMVA had a great impact on the long-term success of this procedure. Continuing secondary antibiotic prophylaxis was not a protective factor against adverse cardiac events in this study. (clinicaltrial.gov registration: NCT04112108).
Databáze: OpenAIRE
Externí odkaz: