Thromboembolic risk is potentially reduced in mitral stenosis shortly after percutaneous mitral valvotomy

Abstract Background Rheumatic mitral stenosis (MS) is a problem in the developing countries. Left atrium (LA) and appendage (LAA) dysfunction are considered determinant factors for thrombus formation even in patients with sinus rhythm (SR). Percutaneous mitral valvotomy (PMV) is a well accepted therapeutic option. However, no available data considers patients with SR as a low risk group for the development of thrombus. Purpose Studying short term impact of PMV on P wave morphology, NT-pro BNP as well as LAA properties in patients with MS and SR. Methods A prospective study was conducted in a tertiary University hospital including 41 patients with symptomatic uncomplicated MS having favorable morphology with sinus Rhythm. P wave duration, amplitude and dispersion, NT-pro BNP, transthoracic and transesophageal echocardiography were carried out directly before and 1 month following PMV. Student t-test was used to compare the variables before and after PMV. Correlation was calculated using Pearson's correlation and multivariate regression analysis was used for prediction of unfavorable outcomes. Results After PMV, 36 (87.8%) patients had a favorable outcome manifested with improvement of NYHA class, valve area, estimated systolic pulmonary artery pressure (sPAP) as well as grade of spontaneous echo contrast (SEC). P wave duration, P wave amplitude and P wave dispersion decreased after PMV (14.97±2.65 vs. 13.21±2.36 ms, 4.01±1.01 vs. 2.51±0.71 ms and 4.01±1.01 vs. 2.51±0.71mv; P