IMMEDIATE AND SHORT-TERM OUTCOMES OF PERCUTANEOUS BALLOON MITRAL COMMISSUROTOMY FOR SEVERE MITRAL STENOSIS AND ASSOCIATED FACTORS, IN CARDIAC CENTER, SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

ABSTRACT BACKGROUND_ Percutaneous mitral balloon commissurotomy (PMBC) is the treatment of choice for patients with mitral valve stenosis (MS) with favorable anatomy and prevents complications inherent to a surgical intervention. AIM_ The aim of this study was to assess immediate and short term outcome of percutaneous balloon mitral commissurotomy for symptomatic patients with rheumatic severe mitral stenosis at Saint Paul’s Hospital Millennium Medical College, Cardiac Center. METHODS- Clinical data of 91 consecutive patients who underwent PMBC at Saint Paul’s Hospital Millennium Medical College, Cardiac Center from February 2018-June 30 2021 were analyzed retrospectively. Demographic, clinical, echocardiographic and hemodynamic (pre and post procedure) data of patients were collected and analyzed. Data was collected with check list and patient telephone contact and was entered and cleaned with Epi Info 7.2.1 and analyzed with SPSS version 25. Paired t-test and Fisher’s Exact Test were used to see association and pvalue ≤ 0.05 was used to show statistically significant association. Results: Of the 91 PMBC done in the center, the majority (91.2%) had successful procedure. The mean age of patients were 28.56 ±8.039 years and 78% were females. The mean Wilkin’s score was 6.62 ± 1.10. After PMBC the mean mitral valve area was increased from 0.799 ± 0.18 cm2 to 1.674 ± 0.37 cm2 and Trans mitral mean pressure gradient was reduced from 20 ± 7.635 mmHg to 7.71 ± 4.40 mmHg(P <0.001). Over all eight (8.8%) patients developed complication, from these two (2.2%) patients developed significant mitral regurgitation. The major predictors identified for poor immediate outcome were atrial fibrillation and high Wilkins score, while the predictor for New York Heart Association functional class improvement 3 months after the PMBC were Wilkin’s score ≤ 8 and Post PMC mitral valve area > 1.5cm2. CONCLUSION-Percutaneous mitral balloon commissurotomy is a safe procedure with excellent immediate and short-term results. Keywords: Percutaneous Mitral Balloon Commissurotomy, Predictors, saint peter specialized hospital Cardiac Center, Ethiopia