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KMID : 0390119930330010091
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Journal of Pusan Medical College
1993 Volume.33 No. 1 p.91 ~ p.98
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The Effect of Percutaneous Mitral Valvuloplasty in Patients with Mitral Stenosis
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Abstract
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Percutaneous mitral valvuloplasty (PMV) suing Inoue balloon technique was performed in 15 symptomatic patients with mitral stenosis who were candidates for mitral valve commissurotomy. There were 13 women and 2 men with a mean age of 33.4±7.1
years(range 35 to 46). There were sinus rhythm in 13 patients and atrial fibrillation in 2 patients. NYHA functional class was 2.13±0.3. Echo score of mitral valve was 8.1±0.8. The mitral valve area and hemodynamic data were much improved after
PMV.
The improvement were an increase in mitral valve area from 1.0±0.2 to 2.1±0.2 ㎠by 2D echo (p<0.05), a decrease in mean diastolic mitral pressure gradient from 11.3±4.5 to 3.4±1.5mmHg (p<0.05), a decrease in mean left atrial pressure from
16.8±6.1
to 5.1±3.9mmHg (p<0.05), and a decrease in mean pulmonary artery pressure from 24.3±8.6 to 14.7±6.6mmHg(p<0.05). Pulmonary vascular resistance increased from 131.5±110.8 to 183.6±104.9 dyne.sec/cm5 immediately after PMV(p<0.05), but
decreased
to
11.9±82.6 dyne.sec/cm5 1 day after PMV(p<0.05). All patents reported improvements in symptoms and in NYHA functional class by a mean of 1.13 class. Treadmill exercise tests were available for 14 patients for comparing physical activity before
and
after
PMV. Physical activity increased in all patents, with an increase in the mean from 5.7±2.3 MET to 8.5±1.5 MET(p<0.05). Mitral regurgitation developed newly or increased in severity of grade I after PMV in 4 patients (26.7%). There was no
left-to-right
shunt greater than 1.3 of Qp/Qs in oxymetric studies performed immediately after PMV. Percutaneous mitral valvuloplasty is effective and safe procedure to relieve mitral valve obstruction and could be an alternative to surgical mitral
commissurotomy in
selected patents with mitral stenosis.
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KEYWORD
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