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Evaluation of the pulmonary artery pressure during Percutaneous Transvenous Mitral Commissurotomy in Rheumatic Mitral Stenosis

Ananda G.C Chitwan Medical College, Nepal

While many literatures reviewed till dates have shown that It takes 3-6 months time period for the reduction of pulmonary artery pressure after PTMC. This study is designed to see pulmonary artery pressure immediately after procedure.   Method: All the patients with Rheumatic Mitral Stenosis in Cath Lab under department of cardiology of Chitwan Medical College from October 1 2018 to August 30 2019 were included in this study   Results: It is a prospective observational study on a total of 42 patients who underwent PTMC, 30 were female and 12 were male. Age ranged from 30 to 61 years with the mean age of 45.36±10 years. The mean mitral valve area increased from 0.87±0.2 cm2 to 1.74±0.17 cm2 whereas Mean Pressure Gradient decreased from 13.59± 7.30 to 5.15±30 as. Mean Pulmonary Artery Pressure decreased from 41.50 ±16.00 to 33.50±12.00. Similarly, the mean left atrial pressure decreased from 26.57±8.62 mmHg to 15.50±5.95 mmhg whereas, the mean Aortic Pressure increased from 91.43 ±23.02 mmHG  to  98.29±24.92 mmHg as assessed by right heart catheterization. Eighteen (42.85%) patients had an increase in MR by 2 grades but there is no need of immediate mitral valve replacement. During procedure, paroxysmal PSVT was noted in six (14.285%) patients and also local hematoma was observed in five (11.90%) patients.   Conclusion: There is reduction of pulmonary artery pressure immediately post PTMC which is directly correlated with left atrial pressure without significant MR and tachycardia.