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Echocardiographic parameters for assessing successful balloon mitral valvuloplasty in juvenile age groups

Published online by Cambridge University Press:  16 November 2015

Ajith Ananthakrishna Pillai ,
Geofi George ,
Harichandrakumar Kottyen Thazhath  and
Sreekanth Yerram
Ajith Ananthakrishna Pillai*
Affiliation:
Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Geofi George
Affiliation:
Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Harichandrakumar Kottyen Thazhath
Affiliation:
Department of Biometrics and Statistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Sreekanth Yerram
Affiliation:
Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
*
Correspondence to: A. A. Pillai, Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar Post, Pondicherry 605006, India. Tel: 0091-4137299; FAX: 4132277167; E-mail: [email protected]
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Abstract

Background

Different echocardiographic parameters have been studied and validated for assessing the severity of mitral stenosis; however, scant data are available for these markers in the context of balloon mitral valvuloplasty in juvenile age groups (ages ⩽20 years).

Objectives

The aim of the present study was to find out the utility of echocardiographic parameters such as mitral valve separation index, left atrial volume, right ventricular systolic pressure, tricuspid annular plane systolic excursion, tricuspid annular systolic velocity, and right ventricular Tei index in predicting success of balloon mitral valvuloplasty and their relation to mitral valve area in juvenile mitral stenosis.

Methods

We carried out a prospective single-centre study involving 52 juvenile mitral stenosis patients undergoing elective valvuloplasty. Success was defined as an increase in mitral valve area ⩾50% or ⩾1.5 cm2. Echocardiographic measurements were taken before and 24 hours after the procedure and statistical analyses were carried out.

Results

The mean age of the study population was 14.3 years (SD ±4.55), ranging from 7 to 20 years. Valvuloplasty was successful in 49 out of 52 patients. The mean valve area improved from 0.89 (SD ±0.16) to 1.73 (SD ±0.22) cm2/m2 (p<0.01), and the mean mitral valve gradient decreased from 19.87 (SD ±7.89) to 7.45 (SD ±2.07) (p=0.021). All the surrogate parameters improved favourably after valvuloplasty (p<0.01). The decrease in right ventricular systolic pressure was a better indicator of the success followed by the increase in valve separation index (area under the curve 0.81 and 0.76, respectively).

Conclusions

All the surrogate markers studied showed favourable improvement, and right ventricular systolic pressure reduction and improved mitral valve separation index were better indicators of successful valvuloplasty.

Keywords

Mitral valve areamitral valve separation indexright ventricular functionballoon mitral valvuloplasty
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 7 , October 2016 , pp. 1266 - 1273
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Copyright
© Cambridge University Press 2015 

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