EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57

Abstract

MORPHOLOGICAL AND HISTOLOGICAL CHARACTERISTICS OF SURGICALLY EXCISED MITRAL VALVE IN PATIENTS WITH RHEUMATIC AND NONRHEUMATIC MITRAL VALVE DISEASE

Dr. Md. Imran*, Dr. Shakhawat Hossain, Dr. Lubna Baset Bristi, Dr. MST. Nadia Yousuf and
Dr. Tahmina Haque

ABSTRACT

Background: Among the rheumatic valvular heart disease; Mitral valve is frequently affected. In the past years, the pathology of cardiac valves has been thoroughly studied at autopsy. Now valve specimen obtained during cardiac surgery allow the study of a greater number of valves which affected by different diseases. Thus, the gross morphological study and histological examination of the surgically excised mitral valves will enhance the knowledge about the nature of rheumatic and nonrheumatic valve diseases. An understanding of the abnormal structure of the mitral valve is critical in choosing the optimal therapeutic approach for affected individuals. Objective: To see morphological and histological characteristics of surgically excised mitral valve in rheumatic and nonrheumatic mitral valve diseases and compare this characteristic between rheumatic and nonrheumatic mitral valve disease. Materials and Methods: This comparative cross sectional study carried out in the department of cardiac surgery, NICVD from first August 2018 to thirteen June 2020. Total 60 patients selected irrespective of age and sex. This patient gone through mitral valve replacement surgery. Results: Total sixty patients selected irrespective of age and sex who underwent through routine mitral valve replacement surgery. Based on past history of rheumatic fever patients divided into two group Rheumatic and nonrheumatic mitral valve disease. Among 60 patients 31(51.67%) were male and 29 (48.33%) were female. Among male, 20 (33.33%) male patients in rheumatic group and 11 (18.33%) male patients in nonrheumatic group. Among female, 24 (40%) female patients in rheumatic group and 5 (8.33%) female patients in nonrheumatic group. Morphological study revealed thickening and fibrosis to varying extent present in 48 (80%) cases. Commissural fusion and reduction of valve area present in 36 (60%) patients, Annular dilatation present in 16 (26.67%) cases, Calcium deposition to varying extent present in 39 (65%) patients, sub valvular changes present in 52 (86.66%) patients. The differences of morphological features were statistically significant (p<0.05) in Chi-Square test (χ2). Morphological study of valve revealed mitral valve is more distorted and had more features than preoperative echocardiography. Histological study revealed among 60 patient fibrosis found in 48 (80%) slide, calcium deposition found in 42 (70%) cases. Aschoff body found in 32 (53.33%) patients, few specimens revealed multinucleated Aschoff giant cell. Differences between rheumatic and non-rheumatic groups was statistically significant (p<0.05). Conclusion: In this study, based on morphologic and histologic features of diseased mitral valve following mitral valve replacement procedure, it can be concluded that in national institute of cardiovascular diseases most mitral valve replacement procedure occur due to Rheumatic mitral valve disease than nonrheumatic mitral valve disease.

Keywords: Mitral Stenosis; Mitral Regurgitation; Rheumatic valvular Heart disease; Non Rheumatic Valvular Heart Disease; Mitral Valve Replacement; Morphology; Histopathology.


[Full Text Article]

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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI ) Scope Database