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OBJECTIVE: To determine the factors responsible for insignificant decrease in
pulmonary artery pressure immediately after percutaneous trans-mitral
commissurotomy (PTMC) in patients of rheumatic mitral stenosis.
METHODS: This cross-sectional study was conducted on patients undergoing
th PTMC at Cardiology Unit, Lady Reading Hospital, Peshawar, Pakistan from 11
th February, 2016 to 28 February, 2018. Pulmonary artery pressure (PAP) was
noted before and after PTMC through echocardiography. Data was analyzed
with SPSS Version 20.0, categorical and continuous variables were described as
frequencies/percentages and mean±SD respectively. Odds ratio was
determined for factors negatively affecting the fall in PAP.
RESULTS: Out of 159 patients, 108 (67.9%) were females. Mean age was
25.38±10.67 years. PAP was insignificantly decreased in patients >30 years
(p>0.05), symptoms for >5 years (p>0.05), left atrium diameter >4.5cm
(p>0.05), atrial fibrillation (p>0.05), right ventricle diameter >2.5cm
(p>0.05) and NYHA IV dyspnea (p>0.05). Odds Ratio for failure of significant
decrease in PAP immediately post-PTMC was 1.68 for age more than 30 years,
1.10 for symptoms more than 5 years, 3.73 for LA diameter more than 4.5 cm,
2.31 for RV diameter more than 2.5 cm , 2.32 for history of atrial fibrillation and
6.71 for NYHA IV dyspnea.
CONCLUSION: Factors which negatively affect the immediate fall in PAP
post-PTMC are age >30years, duration of symptoms >5years, LA diameter
>4.5cm, history of atrial fibrillation, RV diameter >2.5cm and NYHA IV
dyspnea and hence are the poor predictors of successful PTMC while NYHA IV
dyspnea has highest odds for insignificant decrease.
Muhammad Saad Jibran, Syed Abid Habib, Sher Bahadar Khan, Adnan Mahmood Gul. (2019) FACTORS RESPONSIBLE FOR INSIGNIFICANT DECREASE IN PULMONARY ARTERY PRESSURE IMMEDIATELY AFTER PER CUTANEOUS TRANS-MITRAL COMMISSUROTOMY IN PATIENTS OF RHEUMATIC MITRAL STENOSIS, KHYBER MEDICAL UNIVERSITY JOURNAL, Volume 11, Issue 2.
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