CLINICAL PROFILE OF PATIENTS UNDERGOING PERCUTANEOUS BALLOON MITRAL VALVOTOMY AND BODY SURFACE AREA BASED MITRAL VALVE AREA ASSESSMENT

Abstract

Introduction: PBMV has become the procedure of choice for mitral stenosis with suitable valve apparatus. Mitral valve apparatus is related to body surface area and it varies with racial origin. We studied the clinical profile and BSA indexed MVA of patients undergoing PBMV in our institute. Materials & Methods: This was a retrospective study consisting of 103 patients who underwent PBMV in our institute from January 2019 to December 2019. All the patients who fulfilled ACC/AHA [2014] Class I & II-a indications were included and had a detailed clinical and echocardiographic evaluation. BSA was calculated for all the patients using Du Bois formula [BSA = 0.007184 * Height0.725 * Weight0.425] and body surface area indexed MVA was then calculated. Correlation of MVA and BSA indexed MVA with various parameters was done. Results: The study population comprised of 81 females [79%] and 22 males [21%]. Age group of 21-30 had the maximum number of cases undergoing PBMV, comprising 35 cases [34%]. Baseline clinical characteristics were noted. Mean-MVG prior procedure was 15.18 +/- 5.58 mm Hg. Mean-MVA pre-PBMV was 0.84 +/- 0.12 cm2 and when indexed to body surface area it was 0.58 +/- 0.09 cm2/m2. Post-PBMV mean-MVA and MVA indexed to BSA was 1.65 +/- 0.19 cm2 and 1.15 +/- 0.18 cm2/m2 respectively. Both MVA and MVA indexed to BSA showed only weak correlation with dyspnoea grade, LA size, mean-MVG and mean-LAP, with none reaching statistical significance. Conclusion: When compared to studies in other parts of the country and world, MVA varied across different regions. We propose that MVA per BSA might standardize the cut off values across different ethnic population and provide more comparable data for PBMV and other procedures of mitral valve apparatus.