African Journals OnLine
East African Medical Journal

Volume 80 No.4 April 2003
ABSTRACTS

Percutaneous transvenous mitral commissurotomy in juvenile mitral stenosis

G.O. Yonga, MBChB, MMed, Consultant Cardiologist, Hurlingham Heart Clinic, P.O. Box 76555, Nairobi and P. Bonhoeffer, Consultant Cardiologist and Director Paediatric Cardiology Department, The Great Ormond Street Hospital, London, U.K.

Request for reprints to: Dr. G.O. Yonga, Consultant Cardiologist, Hurlingham Heart Clinic, P.O. Box 76555, Nairobi, Kenya

ABSTRACT

Objective: To determine the efficacy and safety of percutaneous transvenous mitral commissurotomy(PTMC), using multi-track double balloon technique in juvenile mitral stenosis.

Design: Open non-randomised intervention.

Setting: Cardiac catheterisation laboratories of The Mater Hospital, The Nairobi Hospital and Kenyatta National Hospital from 1996 to 2001.

Patients: Forty five consecutive patients aged less than 21 years with severe pure mitral stenosis and suitable mitral valve apparatus (leaflets, chordae and papillary muscles) for successful commissurotomy.

Intervention: Percutaneous transvenous mitral commissurotomy under local anaesthesia. Standard left and right heart catheterisation for mitral valve disease. Trans-septal left atrial entry using standard septal puncture technique and left ventricular position secured by superstiff guide-wire. Double-balloon mitral valvotomy on single guide-wire using multi-track balloon catheters.

Main outcome measures: Mitral valve area, left atrial pressures, mitral regurgitation grade, NYHA functional class.

Results: Mitral valve area increased from 0.6±0.19cm2 to 1.9±0.19cm2 (p<0.001), left atrial pressures from 30.5±3.9 mmHg to