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percutaneous mitral balloon commissurotomy

Rajesh Vijayvergiya
Percutaneous Transvenous Mitral Commissurotomy (PTMC) is a standard treatment for critical mitral stenosis. In certain situations such as large left atrium (LA) or low trans-septal puncture, there is technical difficulty in crossing a PTMC balloon across the mitral valve, leading to high failure rate. I hereby describe a case of PTMC successfully performed by using double loop technique to cross the mitral valve.
December 2015: Indian Heart Journal
Jahangir Rashid Beig, Nisar A Tramboo, Hilal A Rather, Imran Hafeez, Vijai Ananth, Ajaz A Lone, Irfan Yaqoob, Irfan A Bhat, Muzaffar Ali
BACKGROUND: Mitral stenosis (MS) is associated with prolonged inter- and intra-atrial electromechanical delays and increased P-wave dispersion, which are markers of atrial fibrillation (AF) risk. This study was conducted to assess the immediate effect of successful percutaneous transvenous mitral commissurotomy (PTMC) on these parameters. METHODS: This single center observational study included 25 patients with severe MS (aged 34.1 ± 7.1 years, with mean mitral valve area (MVA) of 0...
December 2015: Indian Heart Journal
M T Rahman, M M Rahman, M M Islam, M R Khan, S A Haque, A W Chowdhury, A S Majumder, A Rahman, Q I Islam
Rheumatic fever and rheumatic heart disease continue to be the major health problem in all developing countries including Bangladesh. 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. Percutaneous balloon mitral commissurotomy is appealing because the mechanism of valve dilation closely parallels the mechanism of surgical mitral commissurotomy. The technique of balloon mitral commissurotomy has evolved rapidly, with improvements in balloons, guide wires, and the application of double-balloon techniques...
July 2015: Mymensingh Medical Journal: MMJ
Achyut Sarkar, Shailesh Patil, Imran Ahmed
Juvenile rheumatic mitral stenosis (MS) is common in the Indian subcontinent. Early recognition and management is essential. Rarely rheumatic MS may occur in <5 years of age, wherein rapid hemodynamic progression and cardiac morbidity and mortality occurs. Severe/symptomatic MS in preschool age requires urgent and meticulous decision making. Condition of valve and wishes of parents may complicate management decisions. Percutaneous transmitral commissurotomy (PTMC) may, therefore, become the only life-saving intervention in these cases unless contraindicated, although the procedure entails considerable technical issues in this age group...
November 2015: Catheterization and Cardiovascular Interventions
Mike Saji, Michael Ragosta, John Dent, D Scott Lim
OBJECTIVES: To report the efficacy and safety of the use adjunctive intracardiac echocardiography (ICE) during percutaneous transluminal mitral commissurotomy (PTMC) in patients without transesophageal echocardiography (TEE). BACKGROUND: Patients with mitral stenosis are at a high risk of developing a left atrial (LA) thrombus. Traditionally, TEE has been used prior to PTMC to identify the presence of LA thrombi. There have been no reports of the use of ICE to assess the LA for thrombi prior to PTMC...
February 1, 2016: Catheterization and Cardiovascular Interventions
Naser Aslanabadi, Iraj Jafaripour, Mehrnoush Toufan, Bahram Sohrabi, Ahmad Separham, Reza Madadi, Hossein Feazpour, Yosef Asgharzadeh, Mostafa Ahmadi, Abdolrasol Safaiyan, Samad Ghafari
INTRODUCTION: Mitral stenosis (MS) causes structural and functional abnormalities of the left atrium (LA) and left atrial appendage (LAA), and studies show that LAA performance improves within a short time after percutaneous transvenous mitral commissurotomy (PTMC). This study aimed to investigate the effects of PTMC on left atrial function by transesophageal echocardiography (TEE). METHODS: We enrolled 56 patients with severe mitral stenosis (valve area less than 1...
2015: Journal of Cardiovascular and Thoracic Research
J Langerveld, J M P G Ernst, N M van Hemel, W Jaarsma
Percutaneous transvenous mitral balloon valvotomy (PTMV) has been proven to be an effective and safe method for treatment of patients with severe mitral valve stenosis. This technique has become an accepted alternative for surgical commissurotomy, not only in young patients with pliable valves, but also in selected older patients with extensive valvular pathology. This review highlights the significance of coexisting atrial fibrillation, patient selection and timing of PTMV in patients with mitral valve stenosis...
January 2005: Netherlands Heart Journal
Leili Pourafkari, Seyedrazi Seyedhosseini, Babak Kazemi, Heydarali Esmaili, Naser Aslanabadi
INTRODUCTION: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS) due to high left atrium (LA) pressure and pulmonary artery pressure (PAP). Percutaneous transvenous mitral commissurotomy (PTMC) if successful is pursued by a rapid decrease in LA pressure and subsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptide levels could be affected with heart rhythm...
2014: Journal of Cardiovascular and Thoracic Research
Sandeep Goel, Ranjit Nath, Ajay Sharma, Neeraj Pandit, Harsh Wardhan
BACKGROUND: The surgical management of Lutembacher syndrome is straight forward but percutaneous management, though technically demanding, is always desirable. METHODS: A 17 year old unmarried female presented with severe Mitral stenosis and a 19 mm almost circular Ostium secundum ASD with moderate pulmonary artery hypertension and dilated right sided chambers. She was managed in a staged manner. Percutaneous trans mitral commissurotomy (PTMC) was done first, using a 26 mm Inoue balloon catheter set, and after 48 h, ASD was closed with a 20 mm Cocoon Septal Occluder...
May 2014: Indian Heart Journal
Nadeem Sadiq, Maad Ullah, Mehboob Sultan, Khurram Akhtar
OBJECTIVE: To analyze the effectiveness of transthoracic echocardiography (TTE) for device closure of secundum atrial septal defect in children ≤5 years old. STUDY DESIGN: Quasiexperimental study. STUDY LOCATION AND DURATION: The study was conducted at Armed Forces Institute of Cardiology and National Institute of Heart Diseases from December 1, 2010 to December 31, 2012. PATIENTS AND METHODS: During the study period, a total of 48 children ≤5 years old underwent device closure of secundum atrial septal defect...
June 2014: Journal of Invasive Cardiology
Soumen Devidutta, Rajiv Narang, Anita Saxena, Ganesan Karthikeyan
Cor triatriatum is an uncommon congenital anomaly and its coexistence with rheumatic mitral stenosis is rare. We report two patients with rheumatic mitral stenosis with associated cor triatriatum. Percutaneous mitral valvuloplasty was successfully performed in both cases. We describe the clinical presentation and discuss the technical issues related to balloon mitral valvotomy in these cases.
April 2015: Cardiovascular Intervention and Therapeutics
Suresh V Patted, Prabhu C Halkati, Sameer S Ambar, Ameet G Sattur
Double-orifice mitral valve (DOMV) is an uncommon congenital anomaly, being present in 0.05% of the general population. The isolated occurrence of this anomaly is very rare and, to our knowledge, no data are currently available on the incidence of an isolated DOMV. A DOMV is characterized by a mitral valve with a single fibrous annulus with 2 orifices opening into the left ventricle (LV). Subvalvular structures, especially the tensor apparatus, invariably show various degrees of abnormality. It can substantially obstruct mitral valve inflow or cause mitral valve incompetence...
2012: Case Reports in Cardiology
Surender Deora, Chirayu Vyas, Sanjay Shah, Tejas Patel
Percutaneous balloon pulmonary valvuloplasty (BPV) is the mainstay of treatment for significant pulmonary stenosis with doming leaflets. Various techniques have been described in the literature including the use of Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC) catheter with standard 0.025″ guidewire. But if right ventricular anatomy is not suitable, 0.025″ guidewire doesn't provide enough support to track the Inoue PTMC catheter. Here, we report a case of successful BPV using a novel technique of slenderizing the Inoue Percutaneous Transseptal Mitral Commissurotomy (PTMC) catheter over an Amplatz superstiff 0...
March 2014: Indian Heart Journal
Claire Bouleti, Bernard Iung, Dominique Himbert, David Messika-Zeitoun, Eric Brochet, Eric Garbarz, Bertrand Cormier, Alec Vahanian
BACKGROUND: Indications of percutaneous mitral commissurotomy (PMC) remain debated in calcific mitral stenosis. We analyzed long-term results of PMC for calcific mitral stenosis and the factors associated with late functional results. METHODS AND RESULTS: We compared the characteristics and outcome of 314 patients undergoing PMC for calcific mitral stenosis with 710 patients with noncalcified valves followed up to 20 years. Calcification was defined by fluoroscopy, and its extent was graded from 1 to 4...
June 2014: Circulation. Cardiovascular Interventions
Chamrajnagar Mahadevappa Nagesh, Soumya Patra, Ajitpal Singh, Srinivas C Badnur, Babu Reddy, Manjunath C Nanjappa
Marfan's syndrome (MFS) is an inherited autosomal dominant disorder of connective tissue with mutation on the fibrillin-1 gene encoding for fibrillin. This frequently involves the cardiovascular system with prevalence is 1:5000-10,000. The clinical major criteria involve the skeletal and ocular apparatus and the cardiovascular and central nervous system. In Marfan's syndrome mitral valve prolapse and aortic dilation are the main cardiovascular manifestations. According to the literature database the prevalence of aortic dilatation is 76%, 62% for mitral valve prolapse, 29% for mitral valve regurgitation and 26% for aortic regurgitation, in adult patients with Marfan's syndrome...
December 2013: Journal of Cardiovascular Disease Research
Hyun Ju Jung, Ga-Yon Yu, Jung-Ho Seok, Chungsik Oh, Seong-Hyop Kim, Tae-Gyoon Yoon, Tae-Yop Kim
A precise pre-procedural evaluation of mitral valve (MV) pathology is essential for planning the surgical strategy for severe mitral regurgitation (MR) and preparing for the intraoperative procedure. In the present case, a 38-year-old woman was scheduled to undergo MV replacement due to severe MR. She had a history of undergoing percutaneous balloon valvuloplasty due to rheumatic mitral stenosis during a previous pregnancy. A preoperative transthoracic echocardiography suggested a tear in the mid tip of the anterior mitral leaflet...
January 2014: Korean Journal of Anesthesiology
Manuel J Antunes
Closed mitral commissurotomy for rheumatic mitral valve stenosis was used in many tens of thousands of patients with excellent immediate results and durability, many patients having survived more than 20 years without reoperations. Gradually, this procedure was displaced by the open commissurotomy which has the advantage of direct visualisation of all valve components with immediate assessment of the anatomical and functional result. Open commissurotomy is applicable even in moderately fibrosed and/or calcified valves and in the presence of intra-atrial thrombus...
January 1, 2006: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Ravindranath K Shankarappa, Navin Agrawal, Soumya Patra, Satish Karur, Manjunath C Nanjappa
We are presenting an interesting case of a 30-year-old patient taken for percutaneous transvenous mitral commissurotomy (PTMC) for severe rheumatic mitral stenosis in which there was a collection of four unusual occurrences during the course of a procedure. She had recurrent generalized tonic-clonic seizures immediately after femoral sheath insertion requiring the patient to be mechanically ventilated. Subsequently, the pressure tracings recorded with catheters in the aorta and the pulmonary artery showed transient unusually high supra-systemic pulmonary artery pressure...
September 2013: Journal of Cardiovascular Disease Research
Mohamed Eid Fawzy
Percutaneous mitral balloon valvuloplasty (MBV) was introduced in 1984 by Inoue who developed the procedure as a logical extension of surgical closed commissurotomy. Since then, MBV has emerged as the treatment of choice for severe pliable rheumatic mitral stenosis (MS). With increasing experience and better selection of patient, the immediate results of the procedure have improved and the rate of complications declined. When the reported complications of MBV are viewed in aggregate, complications occur at approximately the following rates: mortality (0-0...
July 2010: Journal of the Saudi Heart Association
Syed Tanveer Alam, Tariq Ashraf, Anees Memon
Since its inception in 1982, percutaneous transvenous mitral commissurotomy (PTMC) has gained increasingly wide use internationally in patients with Rheumatic Mitral stenosis. PTMC offers an alternative to surgery in patients who have pliable mitral valve.Very few reasons were reported to abort the procedure when patient lies on the table. This study presents two case reports in which congenital venous anomalies were one of the reasons to terminate the procedure.
January 2013: JPMA. the Journal of the Pakistan Medical Association
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