Effect of Percutaneous Transvenous Mitral Commissurotomy on Right Ventricular Function: A Quasi-Experimental Study

Abstract

Objective: This study aimed to evaluate the changes in right ventricular (RV) function among patients undergoing percutaneous transvenous mitral commissurotomy (PTMC) for mitral stenosis (MS). Methodology: A quasi-experimental study was conducted in the Department of Cardiology at Hayatabad Medical Complex, Peshawar, from April 2021 to October 2021. Initially, baseline transthoracic echocardiography (TTE) was performed, followed by PTMC for all patients. Post-procedure, patients were monitored in the Coronary Care Unit (CCU) for 24 hours. A follow-up TTE was conducted 24 hours post-PTMC to assess changes in RV function, specifically evaluating parameters such as RV systolic pressure (RVSP), right ventricular outflow tract fractional shortening (RVOT-FS), right ventricular Tei index (RV Tei index), RV wall thickness, and pulmonary artery systolic pressure. Results: Significant changes were observed in RV parameters before and after 24 hours of PTMC. The mean change in RVSP was 5.70 ± 4.50 mmHg (p < 0.001). The mean change in RVOT-FS was -1.22 ± 3.02% (p = 0.003). The RV Tei index showed a mean change of 0.14 ± 0.015 (p < 0.001). The mean change in RV wall thickness was 0.10 ± 0.03 mm (p < 0.001). Additionally, pulmonary artery systolic pressure demonstrated a mean change of 17.09 ± 4.20 mmHg (p < 0.001). Conclusion: The findings indicate that PTMC significantly improves right ventricular function in patients with mitral stenosis. These results underscore the importance of PTMC in the management of RV dysfunction associated with mitral stenosis.