Radiographic, echocardiographic and hemodynamic alterations in patients with mitral stenosis undergoing percutaneous balloon mitral valvotomy

Fifteen patients with severe mitral stenosis were subjected to percutaneous balloon mitral valvotomy (PBMV) and were followed up by plain chest radiographs, two-dimensional Doppler echocardiography, and cardiac catheterization. Chest radiographs done within 24 hours of PBMV revealed substantial alterations in pulmonary vascular markings and a reduction of left atrial size by 20 ± 2mm (p < 0.05). Left atrial dimensions by M mode echocardiogram decreased from 52 ± 6 to 46 ± 4 mm (p < 0.05). Immediately after PBMV there were significantly reduced (p < 0.05) left atrial pressure (32 ± 8 to 14 ± 6 mm Hg) and transmitral gradient (20 ± 6 to 4 ± 3 mm Hg), plus an increase in the mitral valve area from 0.7 ± 0.2 to 1.9 ± 0.3 cm (p < 0.05). These results indicate that hemodynamic alterations following PBMV in patients with mitral stenosis are accompanied by significant salutatory changes in left atrial size and pulmonary vascular markings on plain chest radiographs, as early as 24 hours following the procedure. (author). 12 refs., 2 figs., 2 tabs