Mitral stenosis in the young in developing countries

Bhayana, J.N.; Khanna, S K; Gupta, Babita; Sharma, Savita; Gupta, Manoj Kumar; Padmavati, S

doi:10.1016/s0022-5223(19)41698-x

Cited by 15 publications

(2 citation statements)

References 9 publications

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“…Mitral stenosis (MS) is rarely seen in children and adolescents except in developing countries where rheumatic fever is still endemic (4).Rheumatic mitral stenosis in India commonly affects children and young adults less than 20 years old (juvenile MS) (5). MS is rarely seen in children and adolescents but is not uncommon in developing countries where rheumatic fever is still endemic (6). Rheumatic MS in India commonly affects children and young adults less than 20 years old (juvenile MS) (7).…”

Section: Introductionmentioning

confidence: 99%

Comparative study of percutaneous transvenous mitral commissurotomy using ACCURA balloon in juvenile vs adult rheumatic mitral stenosis

Kondethimmanahally Rangaiah,

Cherukumudi,

Dash

et al. 2023

HVT

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Objective: Mitral stenosis (MS) is rarely seen in children and adolescents but is not uncommon in developing countries where rheumatic fever is still endemic. Rheumatic MS in India commonly affects children and young adults less than 20 years old (juvenile mitral stenosis). Although percutaneous transvenous mitral commissurotomy (PTMC) using the ACCURA balloon catheter has been shown to be safe and effective technique in large series of adult patients, reports of this technique in children are scarce.In our study, we aim to evaluate the immediate and early follow-up results of PTMC in 50 patients of rheumatic MS age ≤ 20 years and compare the same with those of the patients aged > 20 years. Methods: Fifty consecutive patients aged ≤ 20 years with symptomatic rheumatic MS who met the inclusion criteria and whose valves are suitable for PTMC formed the cases, another 50 consecutive patients aged > 20 years with similar characteristics formed the control group. PTMC was done for both the groups as per the standard protocol and hemodynamic and echocardiography parameters were noted. Appropriate statistical tests were used to compare these data. Results: The juvenile group had more often severe MS than adult patients at baseline [mitral valve area (MVA) 0.77(0.16) cm 2 vs. 0.86(0.15) cm 2 , p<0.0069]. Atrial fibrillation was rare in juvenile patients (2%). Following PTMC, when absolute MVA was compared between the two groups, there was no significant difference, but when the post-PTMC MVA was indexed to body surface area, the juvenile group had statistically significant increase in indexed MVA as compared to adults [1.28 (0.30) cm 2 /m 2 vs. 1.06 (0.26) cm 2 /m 2 , p<0.0001]. The same significant gain in indexed MVA was maintained at 6 months follow-up in juvenile patients as compared to adults (p<0.001). Juvenile patients also had significantly higher baseline invasive hemodynamic parameters like mean mitral valve gradient [23.44 (8.14) mm of Hg vs. 19.02(5.79) mm of Hg, p<0.002], mean PAP [50.92 (19.16) mm of Hg vs. 40.94 (11.82) mm of Hg, p<0.002] and mean pulmonary vascular resistance index [8.99 (7.29) U/m 2 vs. 5.61 (4.30) U/m 2 , p<0.006] when compared to adult patients. Invasively measured mean left atrial pressure and mean pulmonary capillary wedge pressure were also high in juvenile patients than in adult patient but not statistically significant. Conclusion: Juvenile patients had severe mitral valve disease with severe pulmonary arterial hypertension at presentation, both echocardiographically and hemodynamically than adult patients. Juvenile patients had significantly better immediate echocardiographic and hemodynamic benefits following PTMC than adult patients, and this was observed even at 6 months following the procedure. PTMC is safe and effective in juvenile rheumatic MS. It provides better immediate results in juvenile patients than in adults.

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Section: Introductionmentioning

confidence: 99%

Comparative study of percutaneous transvenous mitral commissurotomy using ACCURA balloon in juvenile vs adult rheumatic mitral stenosis

Kondethimmanahally Rangaiah,

Cherukumudi,

Dash

et al. 2023

HVT

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“…When rheumatic fever is still prevalent, mitral stenosis (MS) is infrequently encountered in children and adolescents, particularly in underdeveloped nations where up to 25% of patients are younger than 20 years of age [5]. The medical term for this condition is juvenile mitral stenosis (JMS).…”

Section: Introdctionmentioning

confidence: 99%

Frequency of Acute Mitral Regurgitation in Post Percutaneous Transvenous Mitral Commissurotomy (PTMC) Patients with Severe Mitrall Stenosis (MS)

Amir¹,

Haq²,

Mustafa³

et al. 2022

PJMHS

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Objective: The goal of this study is to see how often Acute Mitral Regurgitation is in patients with severe mitral stenosis who have undergone a percutaneous transvenous mitral commissurotomy (PTMC). Study Design: Cross-sectional study Pace and Duration: The study was carried out at cardiology department of Lady Reading Hospital MTI, Peshawar and PIMS hospital, Islamabad for the duration of six months from 16th August 2021 to 15th February 2021. Methods: A total of 85 patients of both genders that underwent percutaneous transvenous mitral commissurotomy (PTMC) were included in this study. A detailed demographic profile of recruited patients including age, gender and body mass index (BMI) was compiled after obtaining informed written permission from each patient. A technician with over 10 years of experience examined pre- and post-procedure mitral regurgitation using a transthoracic echocardiography (TTE). Frequency of complication was also recorded. SPSS 21.0 was used to analyze all data. Results: Among 85 patients, there were 65 (76.5%) females and 20 (23.5%) males. Mean age of the patients was 39.8 ±9.54 years and mean BMI 24.6±11.42 kg/m2. Previous commissurotomy was found in 9 (10.5%) cases. Pre-operative mean balloon size 26.5±1.88 and mitral valve area was 1.1±0.32. Frequency of severe mitral regurgitation found in 15 (17.6%) cases. 75 (88.2%) patients had no previous history of commissurotomy and the majority were females. Among 9 cases of severe MR, 4 (44.4%) had no previous history of commissurotomy. Conclusion: According to our study, few PTMC patients had significant mitral regurgitation. Procedure is safe and effective. A multiethnic, multicenter, multicity research is proposed in Pakistan to evaluate genetic, environmental, and hospital-related variables associated with post-procedural problems in patients with severe mitral regurgitation who received PTMC. Keywords: PTMC, Mitral Regurgitation, Post Percutaneous Transvenous Mitral Commissurotomy, Local Site complications, MR, Cardiac Tamponade

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Severity of rheumatic mitral stenosis in children

Shrivastava¹,

Tandon²

1991

International Journal of Cardiology

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Mitral stenosis in the young in developing countries

Cited by 15 publications

References 9 publications

Comparative study of percutaneous transvenous mitral commissurotomy using ACCURA balloon in juvenile vs adult rheumatic mitral stenosis

Comparative study of percutaneous transvenous mitral commissurotomy using ACCURA balloon in juvenile vs adult rheumatic mitral stenosis

Frequency of Acute Mitral Regurgitation in Post Percutaneous Transvenous Mitral Commissurotomy (PTMC) Patients with Severe Mitrall Stenosis (MS)

Severity of rheumatic mitral stenosis in children

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