The therapeutic use of percutaneous transvenous mitral commissurotomy to alleviate mitral stenosis in patients with a high valve score : the PHC experience / Pedro P. San Diego Jr., Antonio C. Pascual, Ramon M. Pineda, Raul D. Jara

BACKGROUND AND AIMS OF THE STUDY: The most common cause of mitral stenosis is rheumatic heart disease. Although it is declining in Western nations, it is prevalent in underdeveloped and developing countries like the Philippines. The present study examined the therapeutic use of percutaneous transvenous mitral commissurotomy (PTMC) to alleviate symptoms of mitral stenosis in patients with a high valve score (Group 1, n=53) and the factors influencing the outcome of the procedure. MATERIALS AND METHODS: The results of PTMC were also compared with patients who underwent PTMC with normal valve scores (Group II, n=417). Both groups had similar baseline characteristics in terms of age, sex, functional class and rhythm. Patients in the study were from the population of those admitted at the Philippine Heart Center and underwent PTMC between January 1989 to June 1999. RESULTS: PTMC was successful in 38 patients in Group I (71.6%) and in 296% in Group II (70.9 percent). Patients who were more likely to have a failed PTMC were those in atrial fibrillation and belonging to the older age group. Of the parameters of the Wilkins Score, only the mitral valve thickness showed a significance in determining outcome, (p=<0.012) CONCLUSION: This study reveals that there is a similar success rate of PTMC at the Philippine Heart Center whether the patient has a high valve score or not.

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