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Related Experiment Videos

Percutaneous Transvenous Mitral Commissurotomy Without Heparin.

Abraham1, Chandrasekar, Sriram

  • 1Chief Cardiologist, Railway Hospital, Perambur, Chennai-600 023, India.

The Journal of Invasive Cardiology
|April 14, 2000
PubMed
Summary

This study found that heparin may not be necessary during percutaneous transvenous mitral commissurotomy (PTMC) for patients with mitral stenosis in sinus rhythm. Omitting heparin during PTMC showed no increased risk of embolism or complications.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Rheumatic mitral stenosis is a common valvular heart disease.
  • Percutaneous transvenous mitral commissurotomy (PTMC) is a standard treatment.
  • Heparin is often used during PTMC, but its necessity is debated.

Purpose of the Study:

  • To evaluate the safety and efficacy of performing PTMC without heparin in patients with rheumatic mitral stenosis in sinus rhythm.
  • To determine if omitting heparin impacts the incidence of embolism or procedural complications.

Main Methods:

  • A prospective study of 629 patients with rheumatic mitral stenosis in normal sinus rhythm.
  • All patients underwent PTMC using the Inoue balloon technique.
  • Echocardiography (transthoracic and transesophageal) was used to exclude left atrial thrombus prior to the procedure.

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  • Heparin was not administered during the PTMC procedure for any patient.

    • Main Results:

    • The PTMC procedure was successfully completed in all patients without heparin.
    • No instances of embolism were observed during the immediate post-procedure period.
    • No embolic events occurred at a median follow-up of 3 months.
    • There were no femoral artery or venous complications.

    Conclusions:

    • Conventional use of heparin during PTMC may not be required for patients in sinus rhythm without left atrial clot.
    • This finding suggests a potential for simplifying PTMC protocols and reducing bleeding risks.