Non Surgical Treatment Approaches for Combined Rheumatic Severe Aortic and Mitral Stenosis

  • Study Overview:
    This study outlines the successful use of percutaneous transvenous mitral commissurotomy (PTMC) and balloon aortic valvotomy (BAV) to treat combined severe aortic and mitral stenosis in two patients. The cases involve advanced imaging techniques, including 4D transoesophageal echocardiography (TEE), and demonstrate how non-surgical methods can significantly reduce surgical risk in high-risk patients.
  • Case 1 – Young Patient with Combined Severe Aortic and Mitral Stenosis:
    A 28-year-old construction worker, symptomatic with exertional dyspnea, was treated with PTMC and BAV, using 4D TEE guidance. The procedure improved the patient’s condition with no complications, and the follow-up showed sustained symptom relief.
  • Case 2 – Older Patient with Comorbidities:
    A 55-year-old patient, with both a history of HIV and Hepatitis B, underwent a staged PTMC followed by Transcatheter Aortic Valve Replacement (TAVR). Despite the complexity, the staged approach was successful, highlighting the versatility of non-surgical techniques in managing multivalvular heart disease.

Further Reading and Resources

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