Changes in pulmonary function.s and left ventricular functions after balloon mitral valvuloplasty

Abstract

The principle pathophysiologic abnormality m MS is the impairment of LV diastolic filling especially in the early rapid filling phase. The status of systolic LV performance in patients with isolated MS is controversial.

BMV is established as a good alternative to surgical valvotomy in management of MS. And in contrast to surgical closed mitral commissurotomy, balloon mitral commissurotomy and open mitral commissurotomy produce excellent and comparable early hemodynamic improvement and are associated with a lower rate of residual stenosis and restenosis and need for reintervention. However, the good results, lower cost and elimination of drawbacks of thoracotomy and cardiopulmonary bypass indicate that balloon mitral commissurotomy should be the treatment of choice for patients with tight pliable rheumatic MS

The aim of this study is to assess the effect of BMV on LV function and spirometeric pulmonary function as well as other echocardiographic and haemodynamic parameters.

15 patients were included in this study. They had symptomatic MS with MVA < 1.5 cm2• They had mitral and aortic regurgitation (if present) not more than grade 2/4.they had echocardiographic mitral valve score :::: 8 according to wilkins et al. (I988) This work was done at Assiut university hospital between April 2000 to June 2001.

All patients were evaluated before and after BMV by full clinical examination, trans-thoracic and trans-esophageal echocardiography. Successful BMV was done in all patients using Inoue balloon technique.