ATRIAL SEPTAL DEFECT AFTER PERCUTANEOUS MITRAL COMMISSUROTOMY : AN ECHOCARDIOGRAPHIC STUDY

Abstract

Acquired defects within the interatrial septum produced as an undesired consequence of trans-septal catheterization have their haemodynamic consequences . The size of the defect and the magnitude of the shunt after percutaneous mitral balloon valvuloplasty ( PMV ) will determine the long term results and possibly future of the procedure " Its. incidence immediately after percutaneous mitral valvuloplasty varies (0-89%) according to the technique used for detection and estimation "" Several methods were used for shunt detection , estimation and follow up of atrial septal defects after balloon mitral valvotomy namely ; oximetry (4.18.19.", angiography 'I, dye-dilution',pulsed Doppler ", contrast echocardiography ""', color Doppler '22'and trans0esophageal color Doppler " Transoesophageal echo is the most sensitive method for detection of left-to-right shunting after mitral balloon commissurotomy , and defects have been reported in % 87 of patients examined within 24 hours of the procedure." The occurrence of an atrial septal defect after Percutaneous Mitral Balloon Valvuloplasty might be related to different pathological and technical factors "" The best independent predictors are the presence of calcification and lower cardiac output In the present study, Regarding mitral valve calcification , it was present in 6 patients ( 30 %) in group "A" and in 15 patients (75 %) in group "B" with a statistically significant difference ( p<0.05) This was reflected on the mitral valve score mean which was ( 5.8 ±1.28 ) in group "A" while it was (8.05±1.19) in group "B" with a statistically significant difference ( p <005). This was reflected on the atrial septa) defect persistence.