Study of mitral valvular heart disease in tertiary care centre

Abstract

Introduction: The study of valvular lesion is OPD and referrals is a randomized study which gives information regarding age and time of presentation. Rheumatic fever played an important role in the development of majority of Mitral Valve lesions. The extent of Mitral valvular damage also accounts to some extent in the dysfunction of other valves and development of complications like Pulmonary Artery Hypertension.
Aims: To study patients with mitral valvular heart disease in a tertiary care Centre.Materials and methods: This is a Prospective observational study conducted at Gandhi medical college and Gandhi hospital, a tertiary care Centre in Secunderabad. The study was approved by the institute ethical committee for a period of 18 months. Our center mainly use St. Judes valve (Mechanical prosthesis).Results: Majority of patients post operatively are maintained INR between 2-3 and as our goal was also to maintain INR between 2-3 all of them were treated with acitrom 3-5 mg, as no resistance developed. Out of 30 patients only 6 presented with a single episode of hemoptysis majority presented with Grade II shortness of breath. The ICU stay on an average was 5 days ± 3 days with an inotropic support of 2 ml/day. In 30 cases we have not come across a single pregnant lady presenting with symptoms as the heart disease in pregnancy varies from 3.33-5%. In 30 patients 2 male presented with CVA though pre-op carotid Doppler was done. All patients of MS and ½ of MR lesions presented with Atrial fibrillation and they were treated accordingly prior to taking up for surgery. 3 females 1 with severe PAH and 2 with mod PAH they were treated with tab. Sildenafil before Surgical intervention. 2/3 of the patients presented with increased size of LA which lead us to have surgical comfort. ¼ of them were LA ligated who were having LA clot to prevent post op CVA. Out of 30 patients majority presented with sub chordal fusion, and depending on we opted For chordal repair.Conclusion: Prevalence of VHD is at risk from 0.7% in those aged 18-44 to 15% in over 60 years of age. The majority disease consisted in our study is MS next to it is MR. There is equal sex preponderance.