Mid-term results of percutaneous transmitral commissurotomy (PTMC) in central iran

Objectives: Percutaneous Trans-Mitral Commissurotomy (PTMC) is an effective non-surgical treatment in patients with severe rheumatic mitral valve stenosis. This study aimed to evaluate the mid-term results of this procedure in central Iran. Methods: This retrospective study was performed on ۱۰۱ patients with severe mitral valve stenosis who underwent successful PTMC from March ۲۰۱۱ to September ۲۰۱۸ in Afshar Hospital in Yazd. At follow-up, all patients underwent clinical examination, two-dimensional and color Doppler echocardiography, and events were recorded. Data were analyzed using SPSS software version ۱۹. Results: The mean age of the patients was ۴۴.۷۹± ۱۱.۷۲ years, and ۸۳.۳% were female. The mean follow-up time was ۳۸.۹۸ ۲۳.۳۳ months (۶-۹۴ months).۲۵.۸% had AF rhythm, and ۱۲% had previous PTMC or OMVC or CMVC. After percutaneous Trans-Mitral Commissurotomy, ۹۷% of patients were in NYHA functional class I, II and the mitral valve area (MVA) increased from ۰.۹۲ ± ۰.۱۸ to ۱.۶۶± ۰.۲۹ cm۲ (p<۰.۰۰۰۱). Pulmonary artery systolic pressure decreased from ۴۶.۹۶± ۱۸.۵۶ mmHg to ۳۸.۴۳±۱۴.۰۲ mmHg (p<۰.۰۰۰۱). The Mean mitral valve gradient decreased from ۱۲.۳۷± ۳.۹۹ mmHg to ۴.۷۹± ۲.۳۸ mmHg (p<۰.۰۰۰۱). Restenosis rate and severe mitral regurgitation resulting in mitral valve replacement (MVR) were ۱۰.۹% and ۲%, respectively. Two patients died because of intracranial hemorrhage (ICH). During the follow-up event, free survival was ۸۲.۲%. Multivariable analysis revealed that the predictors of shorter event-free survival were AF rhythm (HR; ۴.۵, ۹۵%CI;۱.۵۹-۱۲.۹, P=۰.۰۰۵) and post PTMC higher NYHA functional class (HR;۲.۲, CI;۱-۴.۸,p=۰.۰۴۹). Conclusions: Mid-term results of percutaneous transmitral commissurotomy (PTMC) in central Iran are the same as in other parts of the world. This procedure is an effective and low-risk treatment for severe mitral valve stenosis.

کلیدواژه ها:

Survival ، Rheumatic fever ، mitral valve stenosis ، percutaneous trans-mitral commissurotomy