الفهرس 
Precutenous Balloon mitral valvuloplastyOnly 14 pages are availabe for public view
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Abstract
n this study, 20 patients ”15 females and 5 males” with calcific mitral stenosis and mitral
restenosis underwent percutenous metallic mitral
commissurotomy during the period from January 1999 till October 1999.
One case (case no. 10 in the first group) was completely dropped out from the study as cardiac
temponade developed during trial of inter atrial septal puncture & metallic device was not tried in
this case.
All patients were subjected to:
( 1) Thorough clinical examination .
(2) Twelve lead surface electrocardiogram.
(3) Plain X-ray chest and heart.
(4) Echo cardiographic examination .
Patients with pliable mitral leaflets were not included in this study. The total echo cardiographic
score in this study was > 8/16 jn the majority of patients 17I 19 cases with 2 cases (case no. 6
’8) in the znd group .
Patients were divided according to the nature and pathology of the mitral valve into two groups:
group (1): It include 12 patients with calcific mitral stenosis.
group (2): It include 8 patients with mitral restenosis after previous surgical commissurotomy or
balloon valvuloplasty.
The caliber of commissurotome was selected guided by
the body surface area.
The result of PMMC was considered to be optimal if the mitral valve area increased to a value>
1.5cm2 together with an increase of > 25% of the predilatation mitral valve area and a diastolic
pressure gradient > 8 mmHg. The criteria of optimal results was achieved in 10 patients in group
(1) ”patients with calcific mitral stenosis”. The A-V pressure gradient dropped from (15.27+5.4 7)
to (2.09+2.07)mmHg, the mitral valve area increased from 0.98+0.20 to 2.05+0.4 7cm2. The mean
left artial pressure dropped from 30.54+5.78 to 16.81+5.77mmHg. All values were statistically
significant.
In group Z ”patients with mitral restenosis”, optimal outcome was achieved in 5 patients. The A-V
pressure gradient dropped from 16.37+6.02 to 5.25+6.58mmHg. The mitral valve area increased from
1.05+0.19 to 1.85+0.22. The mean left atrial pressure dropped from 28.75+8.53 to 19.62+8.55mmHg.
All valves were statistically significant.
Multivariate analysis showed no predictor can be detected for optima l outcome of PMMC.
The following complications were encountered:
(I) Mitral regurgitation :
Moderate to severe mitral regurgitation occurred 1n Z patients (10%) .
(2) Atrial septal defect:
It was detected in 10 patients (50%).