Demographic, Clinical and Echocardiographic Characteristics of Patients with Rheumatic Mitral Stenosis Treated with Mitral Balloon Valvuloplasty Procedure: A Local Experince

Abstract

Objectives: Rheumatic mitral stenosis (RMS) remains a significant health challenge, particularly in low- and middle-income countries, due to limited access to preventive measures and timely treatment. Percutaneous mitral balloon valvuloplasty (PMBV) has become the preferred treatment for RMS, offering a less invasive alternative to surgical mitral valve replacement. This study aimed to evaluate the demographic, clinical, and echocardiographic characteristics of patients with RMS undergoing PMBV and to assess the procedural outcomes. Materials and Methods: This study included 52 patients who underwent PMBV RMS. Patients with non-RMS, incomplete patient files, or previous valve surgeries were excluded. Results: The procedural success rate was 87%, with better outcomes observed in patients with a Wilkins score ≤8 than in those with a score >8. PMBV resulted in a significant increase in mitral valve area (MVA) (from 1.18±0.19 cm² to 2.27±0.48 cm², p=0.001) and a decrease in both mean mitral valve gradient (from 12.82±3.5 mmHg to 5.97±2.04 mmHg, p=0.001) and maximum mitral valve gradient (from 27.12±14.0 mmHg to 12.70±3.1 mmHg, p=0.001). Although the procedure was generally safe, manageable complications, such as chordal rupture (1 case, 1.9%) and mitral regurgitation (MR) progression, were observed, particularly in patients with higher Wilkins scores. Conclusion: The significant improvements in MVA and reduced gradient observed in our study underscore the effectiveness of PMBV, even in patients with higher Wilkins scores. Although we observed manageable complications, such as chordal rupture and MR progression, the overall safety and efficacy of PMBV in our patient population highlight its value as a practical and effective treatment option for RMS in our clinical setting. These findings support the continued use of PMBV as a standard treatment approach in our region, potentially enhancing the quality of care for patients with this condition.

Keywords

• balloon valvuloplasty
• gradient mitral
• stenosis
• percutaneous
• rheumatic
• wilkins scores