Acute Impact of Balloon Mitral Valvotomy on Left Atrial Functions in Mitral Stenosis

Beig, Jahangir Rashid; Dar, Mohd Iqbal; Kumar, D.N.; Lone, Ajaz Ahmad; Hafeez, Imran; Tramboo, Nisar A.

doi:10.5530/jcdr.2017.4.29

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…It is also one of the most powerful predictors of new-onset AF on follow-up, progression from paroxysmal to persistent AF [ 9 , 10 ], and often precedes LA enlargement [ 11 , 12 ]. Successful percutaneous balloon mitral valvuloplasty (BMV) leads to early improvement in left atrial reservoir and conduit functions, without significantly affecting left atrial pump function [ 13 ]. We sought to evaluate the impact of successful BMV on the left atrial reservoir function and volume in patients with severe mitral stenosis using PALS.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Left Atrial Reservoir Function and Left Atrial Volume After Percutaneous Balloon Mitral Valvuloplasty Using Peak Atrial Longitudinal Strain

Samrat¹,

Sofi²,

Aggarwal³

et al. 2022

Cureus

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To evaluate the impact of successful percutaneous balloon mitral valvuloplasty (BMV) on left atrial (LA) reservoir function and LA volume in patients with severe mitral stenosis (MS) using peak atrial longitudinal strain (PALS). MethodThis was a prospective, non-randomized observational study conducted at the Laxmipat Singhania (LPS) Institute of Cardiology, Kanpur from August 2018 to February 2020 among patients with severe rheumatic MS undergoing BMV to assess LA reservoir function and its volume after BMV using PALS. Inclusion criteria were symptomatic severe rheumatic MS (NYHA ≥II), normal ventricular systolic function, and suitable valve morphology. Exclusion criteria were the coexistence of aortic valve involvement, left atrial appendage clot, mitral leak more than mild, pregnancy, hypertension, diabetes, and coronary artery disease. To assess LA reservoir function and its volume after BMV, PALS was used. LA was divided into six regions of interest and longitudinal strain curves of individual segments together with global strain were recorded. PALS was calculated at baseline 24 hours following the intervention, and at three months of follow-up. ResultSuccessful BMV was performed in 260 patients (109 or 41.9% males and 151 or 58.1% females), resulting in significant improvement in mitral valve area (MVA) (0.89±0.11 cm 2 vs. 1.83±0.3 cm 2 ; p<0.001). The mean age of patients was 26.7±4.7 years; 214 (82.3%) patients were in normal sinus rhythm (NSR) while 46 (17.7%) had atrial fibrillation (AF).Significant improvement in PALS was noted immediately following the procedure (6.5±11.6% vs. 7.7±10.5%; p< 0.001) and it continued to improve at three months of follow-up (6.5±11.6% vs. 11.3±12.5%; p<0.001), which was 24% and 74% improvement from baseline respectively. Significant reduction in indexed left atrial (LA) volume was observed immediately following the procedure (56.8±14.3 ml/m 2 vs 48.4±12.5 ml/m 2 ; p=0.003), and at three months of follow-up (56.8±14.3 ml/m 2 vs. 45.4±13.3 ml/m 2 ; p=0.002). Those with AF had lesser improvement in PALS in comparison to those with NSR (60% vs. 84%; p=0.044) at three months of follow-up. At three months, the increase in PALS was also lower in patients with a history of stroke as compared to those without it (55% vs 80%; p=0.039). Both LA volume and indexed LA volume reduced significantly immediately at 24 hours and during follow-up. ConclusionLA reservoir function, as assessed by PALS, is reduced in patients with severe MS. It improved significantly within 24 hours following BMV and continued to improve at three months of follow-up. It is an underutilized modality among patients of MS for decision-making prior to intervention and to assess the effect of the intervention.

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Section: Introductionmentioning

confidence: 99%

Assessment of the Left Atrial Reservoir Function and Left Atrial Volume After Percutaneous Balloon Mitral Valvuloplasty Using Peak Atrial Longitudinal Strain

Samrat¹,

Sofi²,

Aggarwal³

et al. 2022

Cureus

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“…It was found that PTMC was not only a safe and effective surgery but also greatly improved patients' QOL, underscoring the significance of providing this procedure at an earlier stage of the disease. According to a local study done in 2019 at the Combined Military Hospital in Pakistan, the authors did not notice any post-PTMC problems such localized hematoma, mitral regurgitation, or circulatory compromise [16][17] . The patients' success rate with PTMC (mean age, 40.3 ±2.8) was very high.…”

Section: Discussionmentioning

confidence: 93%

Incidence of Acute Mitral Regurgitation in Patients with Severe Mitral Stenosis after Post Percutaneous Transvenous Mitral Commissurotomy

Gopher¹,

Irfan²,

Hassan³

et al. 2023

PJMHS

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Aim: To determine the incidence of Acute Mitral Regurgitation in severe mitral stenosis patients done with Post Percutaneous Transvenous Mitral Commissurotomy (PTMC). Methodology: This cross-sectional study was held in the Bahawalpur Heart Center, Bahawalpur for the duration of six months from March 2022 to September 2022. The study included 80 patients, regardless of gender, between the ages of 19-80 years and who had not undergone PTMC. Those with mitral regurgitation and mitral stenosis, left atrial clots, and patients with end-stage renal disease were not included in the study. The predefined Proforma was used as a research tool to document the medical records of PTMC patients. The patient's name, age, echo results, sex, course of treatment, complications and post-procedure information are among the variables documented on the proforma. Results: The patients mean age recorded in this study was 43.18 ± 10.33. The maximum of the PTMC patients, were females 65(80%). The majority of PTMC patients were found to have "Trace" MR, which is a very slight leak in a heart valve. Before the procedure, there were 30 (37.5%) patients with trace MR, followed by 27 (33.8%) patients with mild MR. Before the procedure, 8 (10%) patients had no MR-related difficulties, 5 (6.2%) had moderate MR, and 4 (5%) had mild-moderate MR. After the procedure, 63 (78.8%) of the patients experienced "no complications," 12 (15%) of the PTMC patients experienced "severe mitral regurgitation," 4 (5%) experienced a local hematoma, and cardiac tamponade was seen in one patient. Post-procedure, one patient died. Post-stratification research revealed that 61.3% of patients without a prior history of commissurotomy and the majority of female patients had no complications. While 22.4% of those who never had a prior commissurotomy experienced severe MR overall Conclusion: Our research showed that only a small proportion of PTMC patients had severe mitral regurgitation. Overall, the treatment was successful and safe. Keywords: Cardiac Tamponade, Local Site Complications, Post Percutaneous Transvenous Mitral Commissurotomy, PTMC, Mitral Regurgitation, MR

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Acute Impact of Balloon Mitral Valvotomy on Left Atrial Functions in Mitral Stenosis

Cited by 2 publications

References 32 publications

Assessment of the Left Atrial Reservoir Function and Left Atrial Volume After Percutaneous Balloon Mitral Valvuloplasty Using Peak Atrial Longitudinal Strain

Assessment of the Left Atrial Reservoir Function and Left Atrial Volume After Percutaneous Balloon Mitral Valvuloplasty Using Peak Atrial Longitudinal Strain

Incidence of Acute Mitral Regurgitation in Patients with Severe Mitral Stenosis after Post Percutaneous Transvenous Mitral Commissurotomy

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