Immediate and Short-Term Impacts of Successful Percutaneous Transvenous Mitral Commissurotomy on Right Ventricular Function

AUTHORS

Saman Rostambeigi ORCID 1 , Azin Alizadehasl ORCID 1 , * , Hossein Mahmoudian ORCID 1 , Hamidreza Sanati ORCID 1 , Zohre Mohammadi ORCID 2

1 Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran

2 Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran

How to Cite: Rostambeigi S, Alizadehasl A, Mahmoudian H, Sanati H, Mohammadi Z. Immediate and Short-Term Impacts of Successful Percutaneous Transvenous Mitral Commissurotomy on Right Ventricular Function, Int Cardio Res J. 2020 ; 14(3):e101968.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 14 (3); e101968
Published Online: September 01, 2020
Article Type: Research Article
Received: February 17, 2020
Accepted: August 24, 2020
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Abstract

Background: Mitral valve is the most frequent valve that is affected by rheumatic heart
disease. Abnormalities of Right Ventricular Function (RVF) play an important role in
the development of clinical symptoms and the overall prognosis of patients with Mitral
Stenosis (MS). Previous studies have shown discordant findings regarding the effect of
Percutaneous Transvenous Mitral Commissurotomy (PTMC) on RVF.
Objective: This study aimed to evaluate the immediate and short-term impacts of PTMC
on RVF using two-dimensional and tissue Doppler echocardiographic indices.
Methods: RVF was measured using transthoracic echocardiography indices (Tricuspid
Annular Plane Systolic Excursion (TAPSE) and Peak Systolic Myocardial Velocity by
DTI (RVSm)) in 75 patients with isolated severe MS presented to Rajaie Cardiovascular,
Medical and Research Center between March 2016 and February 2019 before, after, and
six months after PTMC.
Results: All procedures were done successfully. The echocardiographic mean Mitral
Valve Area (MVA) increased significantly from 1.0 ± 0.2 to 1.4 ± 0.2 cm (P < 0.001) and
the mitral valve mean gradient decreased significantly from 10.2 ± 5.3 to 6.3 ± 2.8 mmHg
after successful PTMC (P < 0.001). Systolic Pulmonary Artery Pressure (SPAP) also
decreased significantly from 44.7 ± 11.3 to 35.9 ± 8.4 mmHg after PTMC (P < 0.001) and
to 35.1 ± 6.7 mmHg after the six-month follow-up (P < 0.001). RVSm was 11.3 ± 2.5 cm/s
before PTMC, which did not change immediately after that, but decreased to 12.1 ± 1.9
cm/s after the six-month follow-up (P < 0.003). TAPSE was 19.5 ± 4.3 mm before PTMC,
which significantly increased to 21.1 ± 3.2 mm six months after PTMC (P < 0.005).
Conclusion: This study suggested that successful PTMC could improve RVF and
decrease pulmonary artery pressure.

© 0, Shiraz University of Medical Sciences.

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