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Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2:1. Mitral valve calcification has have shown to be an important factor In determining an immediate outcome of patients undergoing surgical mitral commissurotomy.
A prospective study was done during the period of August 2003 to November 2015. Nineteen hundred and eighty (1980) patients with rheumatic mitral stenosis who underwent PTMC were evaluated clinically, by echocardiography and by catheter during and after the procedure. Out of 1980 patients, 80 patients had fluoroscopically visible mitral valve (MV) calcification (Group-1) and rest 1900 patients had no fluoroscopically visible mitral valve (MV) calcification (Group-2).
Mean age of the study population was 44.25 ± 08.40 years in group-1 and 29.14 ± 12.31 years in Group-2. Most of the population are female, 72% in Group-1 and 75% in group-2. After PTMC mean mitral valve area increased from 0.70 ± 0.15 cm2 to 1.46 ± 0.34 cm2 as measured by echocardiography in group-1 and from 0.82 ± 0.22 cm2 to 1.81 ± 0.33 cm2 in group-2 . Mitral valve gradient reduced to 12.73 ± 4.19 mmHg from 33.56 ± 04.94 mmHg after PTMC in group-1 and 11.75 ± 3.67 mmHg from 27.34 ± 04.34 mmHg after PTMC in group-2. Mean left atrial pressure as recorded by catheter before PTMC was 32.99 ± 08.58 mmHg while after PTMC it was 22.72 ± 05.38mmHg in group-1 and in group-2, 29.72 ± 06.27 mmHg before while after PTMC it was 22.76 ± 05.12 mmHg in group-2.
PTMC can be performed effectively and safely in patients had fluoroscopically visible mitral valve (MV) calcification with a good immediate result but the result is inferior to patients had no fluoroscopically visible mitral valve (MV) calcification.