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Percutaneous transluminal mitral commissurotomy for rheumatic mitral stenosis in a 5-year-old child

Maad Ullah1, Mehboob Sultan, Hajira Akbar

  • 1Department of Pediatric Cardiology, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, Pakistan.

Pediatric Cardiology
|February 22, 2012
PubMed

Insights

Percutaneous transluminal mitral commissurotomy (PTMC) successfully treated severe rheumatic mitral stenosis in a young child. This minimally invasive procedure improved valve function and symptoms, offering a surgical alternative.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Rheumatic mitral stenosis (MS) is a significant cause of heart disease in children.
  • Severe MS can lead to heart failure and pulmonary hypertension.
  • Surgical intervention carries risks, especially in very young patients.

Observation:

  • A 5-year-old boy weighing 11 kg presented with severe rheumatic mitral stenosis.
  • The patient underwent percutaneous transluminal mitral commissurotomy (PTMC) using a valvuloplasty balloon.
  • This was the youngest and smallest patient reported to undergo successful PTMC for rheumatic MS.

Findings:

  • Post-PTMC, the mean mitral valve pressure gradient decreased from 22 mmHg to 6 mmHg.
  • Mitral valve area increased from 0.4 cm(2) to 0.8 cm(2) immediately post-procedure.
  • Follow-up revealed further improvement: mitral valve area increased to 1.0 cm(2), pulmonary arterial pressure decreased, and mean gradient was 8 mmHg with trivial regurgitation.

Implications:

  • PTMC is a safe and effective treatment for severe rheumatic MS in pediatric patients.
  • This minimally invasive approach can be a viable alternative to open-heart surgery.
  • Successful PTMC in this young child suggests broader applicability in pediatric populations.

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