Effect of percutaneous balloon mitral valvotomy on pulmonary venous flow in severe mitral stenosis.
OBJECTIVE
To study the effect of percutaneous balloon mitral valvotomy (PBMV) on the deranged systolic and diastolic pulmonary venous flows in mitral stenosis.


METHODS
Open, non-randomised, case-control study.


METHODS
Mater Misericordiae Cardiac Catheterisation Laboratory and Kenyatta National Hospital Cardiac Catheterisation Laboratory.


METHODS
Twelve consecutive patients with severe symptomatic mitral stenosis with valve characteristics suitable for PBMV on echocardiographic evaluation.


METHODS
Percutaneous baloon mitral valvotomy.


METHODS
Peak systolic and diastolic pulmonary flow velocities and velocity time integrals (VTI).


RESULTS
Peak sytolic pulmonary flow velocity increased from 29.8 +/- 9.6 to 46.1 +/- 8.5 cm/s p < 0.01) and systolic VTI from 2.6 +/- 1.0 to 5.5 +/- 0.9 cm (p < 0.01). Peak diastolic flow velocity increased from 39.3 +/- 5.7 to 43.0 +/- 6.9 cm/s (p < 0.05) and diastolic VTI from 3.9 +/- 1.5 to 4.8 +/- 1.6 cm (p < 0.05). Mean mitral valve area increased from 0.65 +/- 0.15 to 1.98 +/- 0.34 cm2 (p < 0.001) and mean left atrial pressures from 30.5 +/- 9.1 to 11.9 +/- 5.1 mmHg (p < 0.001).


CONCLUSIONS
In patients with severe mitral stenosis and sinus rythm, left atrial filling is biphasic with diastolic preponderance. Successful PBMV causes predominant increase in atrial systolic filling.
Yonga
G O
GO
Mater Hospital Heart Unit, University of Nairobi.
Jowi
C A
CA
Bonhoeffer
P
P
D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002404:Catheterization / Q000379:methods*; D002648:Child; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000628:therapy*; D011667:Pulmonary Veins / Q000503:physiopathology*; D016896:Treatment Outcome