Immediate Effects of Increase in Mitral Valve Area on Transvalvular Gradient and pulmonary Artery Pressure after Balloon Mitral Valvuloplasty in Patients with Mitral Stenosis (Running title : Balloon mitral valvuloplasty)

Aims: The purpose of this study was to determine whether there is any association between the optimal increase in mitral valve area and mitral transvalvular gradient decrement and pulmonary arterial pressure decrement after balloon mitral valvuloplasty (BMV) in patients with mitral stenosis. Methods: The study population consisted of 49 patients (47 women, 2 men; mean age = 43.7±13.35 years) with symptomatic rheumatic mitral stenosis who underwent balloon mitral valvuloplasty. Optimal immediate outcome of BMV is defined as a valve area increment of 50% or more or a final mitral valve area of ≥1.5 cm2 and mitral regurgitation Sellers grade ≤ 2. Mitral valve area, mitral transvalvular peak pressure gradient, mitral transvalvular mean pressure gradient, and pulmonary arterial pressure were measured before and 24-48 hours after balloon mitral valvuloplasty, and differences were compared between patients with successful and unsuccessful optimal outcomes. Results: There was a direct relationship between mitral valve area enhancement and amount of reduction in mitral transvalvular peak and mean pressure gradient and pulmonary arterial pressure. Conclusion: After BMV, mitral transvalvular peak pressure gradient, mitral transvalvular mean pressure gradient, and pulmonary arterial pressure reduction were significantly higher in patients with optimal outcome compared with those with suboptimal outcome