Outcome of PTMC with or without Heparin

1
Immediate and In-hospital Outcome of Percutaneous
Transvenous Mitral Commissurotomy with or without
heparin in patients with Mitral Stenosis.
2

• Md. Toufiqur Rahman MBBS, FCPS, MD, FACC, FESC,
  FAPSIC, FAPSC, FRCP,FAHA1
• Syed Azizul Haque MBBS, FCPS, MD, FACC, FRCP2
• AAS Majumder MBBS, D.CARD, MD, FACC, FRCP,FESC,
  FSCAI3
• Afzalur Rahman MBBS, MD, PhD, FACC, FRCP4
• Associate Professor, Department of Cardiology,
  National Institute of Cardiovascular Diseases,
  Dhaka.
• Professor, Department of Cardiology, Dinajpur
  Medical College Hospital.
• Director and Professor, Department of Cardiology,
  National Institute of Cardiovascular Diseases,
  Dhaka.
• Professor, Department of Cardiology, National
  Institute of Cardiovascular Diseases, Dhaka.

3
Correspondence to Dr. Md. Toufiqur Rahman,
MBBS, FCPS, MD, FACC, FESC, FAPSIC, FAPSC, FRCP,
FAHA Associate Professor, Cardiology, Room
No.225, North Block, National institute of
Cardiovascular Diseases (NICVD), Dhaka., E-mail
drtoufiq19711_at_yahoo.com drtoufiq1971_at_gmail.com
4
Background
Rheumatic fever and rheumatic heart disease
continue to be the major health problem in all
developing countries including Bangladesh.
Percutaneous Transvenous mitral Commissurotomy
(PTMC) is an established non-surgical modality
for the treatment of severe rheumatic mitral
valve stenosis.
5
Aim
To compare immediate and in-hospital outcome of
PTMC with or without heparin administration.
6
Method
The study group included 552 consecutive patients
who underwent PTMC at the National Institute of
cardiovascular Diseases (NICVD), Dhaka and Al
Helal Heart Institute, Mirpur, Euro-Bangla Heart
Hospital, Lalmatia, Dhaka between May 2003 and
December 2012. Safety, efficacy and in-hospital
results of percutaneous transvenous mitral
commissurotomy were analyzed in 264 patients
with heparin (group 1) and compared with 288
those of without heparin(group 2). Heparin was
allocated randomly.
7
Results
8
Table-I Baseline Demographic Characteristics
9
Table -II Baseline Clinical and
Echocardiographic Characteristics 
10
Table II1  Hemodynamic Characteristics before
PTMC
  Parameters Group-I
Group-II P
Value (with heparin) (without
heparin) N 264
N288 MVA ( cm2 ) 0.85 0.09
0.85 0.25
NS Transmitral gradient-MPG mmHg ) 26 03
22 06
NS LA size ( mm ) 51 05
48 10
NS LA Pressure (mmHg) 52 08
4709
NS Aortic Pressure mmHg
) 8711 9411
NS
11
Hemodynamic Characteristics after PTMC
12
Table -V Complications and In- hospital events
13
CONCLUSIONS
Heparin administration during PTMC is not
associated with any additional protective effect
against embolic events during procedure and
in-hospital stay.
14
Thank You