Percutaneous mitral balloon commissurotomy (PMBC) is the treatment of choice for rheumatic mitral stenosis with favorable anatomy and prevents complications inherent to a surgical procedure, while maintaining effectiveness. In view of this, we examined the immediate outcome and its predictors of patients undergoing PMBC in our Cardiac Center and availed evidence based information for future use of the treatment in Ethiopia. A retrospective data analysis of 330 patients with symptomatic severe mitral stenosis treated with PMBC using Inoue balloon in the cardiac center Ethiopia from 2014 to 2018 were assessed for their clinical outcome for those who presented for the first time in our cardiac center, Addis Ababa. Demographic, clinical, echocardiographic and hemodynamic data of all patients with symptomatic severe mitral stenosis were collected and analyzed. Of the 330 PMBC performed during the 5 years in the center, the majority had successful procedure (97.88%) and optimal result (92.42%). Twenty four (7.2%) had complications of which 7 (2.1%) had failed procedure and 9 (2.7%) marked mitral regurgitation. Atrial fibrillation was observed in 67 (20.3%). The mean mitral valve score (MVS) was 7.3± 1.35 ranged from 4 to 13. A significant association of immediate outcome was observed with atrial fibrillation (AOR=4.41; 95% CI=1.51 to 12.89) and high mitral valve total Wilkins score (AOR=0.25; 95% CI 0.09 to 0.70). The major predictors identified for poor outcome are atrial fibrillation and MVS. Percutaneous mitral balloon commissurotomy is a safe procedure with excellent immediate results signifying that it is a treatment of choice for heterogeneous group of patients with rheumatic mitral stenosis.

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Background Prosthetic Valve Thrombosis (PVT) is rare but life threatening condition which requires urgent intervention. Patient treatment outcome is not well studied in resource limited settings and the current study aims to explore the treatment outcome of patients with PVT at the Cardiac Center of Ethiopia. Methods The study was conducted at the Cardiac Center of Ethiopia which provides heart valve surgery. All patients who were diagnosed and managed for PVT in the center during the period July 2017 to March 2022 were included in the study. Data were collected through chart abstraction by using a structured questionnaire. Data analysis was done using SPSS version 20.0 for windows software. Result Eleven patients (13 episodes of stuck valve) with PVT were included in the study and nine of them were female. The median age was 28 years old (IQR 22.5–34.0) with the youngest and oldest patients being 18 and 46 years old respectively. All the patients had bi-leaflet prosthetic mechanical valves (10 at mitral valve, two at aortic and mitral and one at aortic positions). The median duration of valve replacement before having PVT was 36 months (IQR 5–72). All patients reported good adherence to anticoagulant therapy; yet only five had optimal INR value. Nine patients presented with failure symptoms. Eleven patients received thrombolytic therapy and nine of them responded to it. One patient operated for failed thrombolytic therapy. Two patients responded to heparinization and optimization of anticoagulant therapy. Of the ten patients who received streptokinase, two of them developed fever and one patient developed bleeding as a complication of the treatment. All the patients survived hospital discharge. Conclusion Prosthetic valve thrombosis was accompanied by sub-optimal anticoagulant therapy. Most patients responded to medical therapy alone.

Background: Mitral stenosis is the most common valvular heart disease during pregnancy. When severe, it leads to significant maternal and fetal morbidity and mortality. Percutaneous mitral valve balloon commissurotomy can be performed during pregnancy, and the present study aimed to describe the immediate maternal and fetal outcomes after percutaneous mitral valve balloon commissurotomy was done in a cohort of 23 pregnant patients with severe mitral stenosis in Addis Ababa, Ethiopia. Methods: Included in the current study were all pregnant mothers who had severe rheumatic mitral valve stenosis and who underwent percutaneous mitral valve balloon commissurotomy at the Cardiac Center of Ethiopia over 6-year period. Data were collected through chart abstraction using a structured proforma and then analysed using STATA version 13.0. Result: Median gestational age was 22 weeks and percutaneous mitral valve balloon commissurotomy was successful resulting in a significant increase in the mean mitral valve area of the group from 0.78 ± 0.20 cm2 to 1.89 ± 0.31 cm2 (p < 0.001). The mean mitral valve inflow gradient of the group was 23.95 ± 6.27 mmHg and 6.80 ± 2.44 mmHg, respectively, before and after the percutaneous mitral valve balloon commissurotomy procedure (p < 0.001). Post-procedure, there was no significant increment in mitral valve incompetence. The mean pulmonary artery pressure of the group decreased from 77.68 ± 23.19 mmHg to 42.31 ± 9.95 mmHg (p < 0.001). There was no fetal or maternal death following the procedure. Pregnancy ended at term gestation for 19/23 (82.6%) of the mothers and the mean birth weight of the neonates was 2800 g. Conclusion: Percutaneous mitral valve balloon commissurotomy procedure can safely be done for severe symptomatic rheumatic mitral stenosis in pregnancy in our setting.