[Percutaneous mitral commissurotomy: immediate and short-term results]

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Mitral stenosis (MS) is a significant valvular heart disease.
• Surgical options for MS can be invasive.
• Percutaneous transvenous mitral commissurotomy (PTMC) offers a less invasive alternative.

Purpose of the Study:

• To evaluate the efficacy and safety of PTMC using the Inoue catheter in patients with severe mitral stenosis.
• To assess procedural success rates, hemodynamic changes, and clinical outcomes.

Main Methods:

• 31 symptomatic patients with mitral stenosis (MS) underwent PTMC with an Inoue catheter.
• Patient selection was based on echocardiographic scores (mobility, thickening, calcification) ≤ 8.
• Hemodynamic parameters (left atrial pressure, mitral diastolic pressure gradient, mitral valve area) were measured pre- and post-procedure.
• Complications and clinical follow-up (3 months, 6 months, 1 year) were assessed.

Main Results:

• PTMC was successful in 30 out of 31 patients.
• Significant improvements were observed in mean left atrial pressure (26 to 14.6 mmHg) and mitral diastolic pressure gradient (8.9 to 3.9 mmHg).
• Mitral valve area increased significantly (0.94 to 1.96 cm²), and remained stable at 6 months and 1 year follow-up.
• 96.6% of patients showed functional improvement within 3 months.
• Complications included mild mitral regurgitation in 11 patients and 2 cases of heart tamponade.

Conclusions:

• PTMC with the Inoue catheter is an effective and safe alternative to open surgery for selected patients with tight mitral stenosis.
• The procedure leads to significant hemodynamic improvement and sustained functional class improvement.
• The transseptal technique is the primary source of procedural hazards.