{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:59:32Z","timestamp":1781643572904,"version":"3.54.5"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":40,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rheumatic heart disease (RHD) remains a major cause of acquired valvular heart disease in low- and middle-income countries, disproportionately affecting young people. The mitral valve is most frequently involved, and severe rheumatic mitral stenosis (MS) represents the dominant presentation. MS is a progressive disease that gradually impairs cardiac output and, if untreated, leads to pulmonary hypertension, right-sided heart failure, and premature death. Percutaneous mitral balloon commissurotomy (PMBC) is considered the first-line intervention for symptomatic severe MS with favorable valve anatomy. This study aimed to assess the clinical, echocardiographic, and procedural outcomes of PMBC among juvenile patients with rheumatic MS in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A Descriptive cross-sectional study was conducted at the Cardiac Center Ethiopia, Addis Ababa, from July to August 2025. All consecutive patients who underwent PMBC during the study period and fulfilled eligibility criteria were included (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200986). Data were analyzed using STATA 17. Continuous variables were expressed as means\u2009\u00b1\u2009SD or medians (IQR), and categorical variables as frequencies and percentages. Pre- and post-procedure echocardiographic and clinical parameters were compared using paired statistical tests. Associations between baseline characteristics and immediate outcomes were examined using Fisher\u2019s exact tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 15 years (\u00b1\u20095), and 60.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200952) were female. Patients originated from multiple Ethiopian regions, predominantly Amhara 28 (32.6%) and Oromia 25 (29.1%), with 65.06% residing in Rural areas. Severe MS accounted for 84 (97.7%) of cases, while 2 patients (2.3%) presented with severe restenosis. 82 (95.4%) had a mitral valve score\u2009\u2264\u20098. The mitral valve area increased significantly from 0.6\u00a0cm\u00b2 (IQR: 0.26) to 1.5\u00a0cm\u00b2 (IQR: 0.6), and the mean mitral gradient decreased from 31.4\u2009\u00b1\u20098.3 mmHg to 16.4\u2009\u00b1\u20095.6 mmHg (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Procedural success was achieved in 85 cases (98.84%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PMBC in juvenile patients with severe rheumatic MS in Ethiopia is a safe and effective intervention, demonstrating significant improvements in mitral valve area and mean mitral gradient, with a high procedural success rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05770-4","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:32:10Z","timestamp":1774420330000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous mitral balloon commissurotomy in juvenile rheumatic mitral stenosis patients: a ten-year experience from Ethiopia"],"prefix":"10.1186","volume":"26","author":[{"given":"Mohammed Bedru","family":"Sebah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azene Dessie","family":"Mengistu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilahun Dessie","family":"Alene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdu Endris","family":"Assefa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adisu Meles","family":"Kabtyimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"5770_CR1","unstructured":"World Health O. Rheumatic heart disease Fact sheet. 2023."},{"issue":"8","key":"5770_CR2","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1056\/NEJMoa1603693","volume":"377","author":"DA Watkins","year":"2017","unstructured":"Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, et al. Global, regional, and national burden of rheumatic heart disease, 1990\u20132015. N Engl J Med. 2017;377(8):713\u201322.","journal-title":"N Engl J Med"},{"key":"5770_CR3","doi-asserted-by":"publisher","first-page":"205031212311693","DOI":"10.1177\/20503121231169389","volume":"11","author":"T Asfaw","year":"2023","unstructured":"Asfaw T. Prevalence of rheumatic heart disease in Ethiopia: A systematic review and meta-analysis. SAGE Open Med. 2023;11:20503121231169389.","journal-title":"SAGE Open Med"},{"issue":"1","key":"5770_CR4","first-page":"9","volume":"52","author":"SG Abdissa","year":"2014","unstructured":"Abdissa SG, Oli K, Feleke Y, Goshu DY, Begna DM, Tafese A. Spectrum of cardiovascular diseases among Ethiopian patients at Tikur Anbessa Specialized University Teaching Hospital, Addis Ababa. Ethiop Med J. 2014;52(1):9\u201317.","journal-title":"Ethiop Med J"},{"issue":"1","key":"5770_CR5","first-page":"165","volume":"35","author":"S Nulu","year":"2017","unstructured":"Nulu S, Bukhman G, Kwan GF. Rheumatic Heart Disease: The Unfinished Global Agenda. Cardiol Clin. 2017;35(1):165\u201380.","journal-title":"Cardiol Clin"},{"issue":"3","key":"5770_CR6","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.jsha.2010.04.013","volume":"22","author":"ME Fawzy","year":"2010","unstructured":"Fawzy ME. Mitral balloon valvuloplasty. J Saudi Heart Assoc. 2010;22(3):125\u201332.","journal-title":"J Saudi Heart Assoc"},{"issue":"3","key":"5770_CR7","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/S0022-5223(19)37390-8","volume":"87","author":"K Inoue","year":"1984","unstructured":"Inoue K, Owaki T, Nakamura T, Kitamura F, Miyamoto N. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984;87(3):394\u2013402.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"5770_CR8","doi-asserted-by":"crossref","unstructured":"Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA\/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):e521\u2013643.","DOI":"10.1161\/CIR.0000000000000031"},{"issue":"24","key":"5770_CR9","doi-asserted-by":"publisher","first-page":"2480","DOI":"10.1001\/jama.2021.2133","volume":"325","author":"LJ Davidson","year":"2021","unstructured":"Davidson LJ, Davidson CJ. Transcatheter treatment of valvular heart disease: a review. JAMA. 2021;325(24):2480\u201394.","journal-title":"JAMA"},{"issue":"8","key":"5770_CR10","first-page":"875","volume":"7","author":"MJ Swaans","year":"2014","unstructured":"Swaans MJ, Bakker AL, Alipour A, Post MC, Kelder JC, de Kroon TL, et al. Survival of transcatheter mitral valve repair compared with surgical and conservative treatment in high-surgical-risk patients. JACC: Cardiovasc Interventions. 2014;7(8):875\u201381.","journal-title":"JACC: Cardiovasc Interventions"},{"issue":"4","key":"5770_CR11","first-page":"34","volume":"9","author":"N Braiteh","year":"2019","unstructured":"Braiteh N, Zgheib A, Kashou AH, Dimassi H, Ghanem G. Immediate and long-term results of percutaneous mitral commissurotomy: up to 15 years. Am J Cardiovasc Dis. 2019;9(4):34\u201341.","journal-title":"Am J Cardiovasc Dis"},{"issue":"3","key":"5770_CR12","doi-asserted-by":"publisher","first-page":"e14114","DOI":"10.1111\/eci.14114","volume":"54","author":"RK Mutagaywa","year":"2024","unstructured":"Mutagaywa RK, Kifai E, Elinisa M, Mayala H, Kisenge P, Shemu T, et al. Comparison between interventional versus medical therapy in patients with rheumatic mitral valve stenosis in Tanzania. Eur J Clin Invest. 2024;54(3):e14114.","journal-title":"Eur J Clin Invest"},{"issue":"3","key":"5770_CR13","first-page":"55","volume":"3","author":"MB Sebah","year":"2019","unstructured":"Sebah MB, Tadesse KD, Mohammed AD, Debel FA, Agonafir ST, Mengistu AD, et al. Immediate outcome and predictors of percutaneous Mitral Balloon commissurotomy: a 5 years experience in cardiac center Ethiopia. Cardiol Cardiovasc Res. 2019;3(3):55.","journal-title":"Cardiol Cardiovasc Res"},{"key":"5770_CR14","unstructured":"Bishop MA, Alahmadi MH, Borsody K. Mitral Commissurotomy. StatPearls. 2025."},{"issue":"4","key":"5770_CR15","first-page":"e24610","volume":"14","author":"S Khanal","year":"2022","unstructured":"Khanal S, Yamasandi Siddegowda S, Kumar B. Balloon Mitral Valvotomy With the Accura Double-Lumen Balloon Catheter: Immediate and One-Year Clinical Outcomes. Cureus. 2022;14(4):e24610.","journal-title":"Cureus"},{"issue":"1","key":"5770_CR16","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1213\/ANE.0000000000001276","volume":"123","author":"AD Cherry","year":"2016","unstructured":"Cherry AD, Maxwell CD, Nicoara A. Intraoperative Evaluation of Mitral Stenosis by Transesophageal Echocardiography. Anesth Analg. 2016;123(1):14\u201320.","journal-title":"Anesth Analg"},{"issue":"1","key":"5770_CR17","doi-asserted-by":"publisher","first-page":"17","DOI":"10.5334\/gh.1402","volume":"20","author":"J Zhang","year":"2025","unstructured":"Zhang J, Jia S, Chen Y, Han J, Zhang H, Jiang W. Recent advances on the prevention and management of rheumatic heart disease. Global Heart. 2025;20(1):17.","journal-title":"Global Heart"},{"key":"5770_CR18","doi-asserted-by":"publisher","first-page":"2333794x2412988","DOI":"10.1177\/2333794X241298811","volume":"11","author":"TT Libe","year":"2024","unstructured":"Libe TT, Kelil YE, Tegene SA, Hassen FA, Mesfin KH. Clinical Characteristics and Valve Lesions in Rheumatic Heart Disease Among Children at Hiwot Fana Comprehensive Specialized Hospital: A Comparative Study of Newly Diagnosed and Known Cases. Glob Pediatr Health. 2024;11:2333794x241298811.","journal-title":"Glob Pediatr Health"},{"key":"5770_CR19","doi-asserted-by":"publisher","first-page":"101754","DOI":"10.1016\/j.ppedcard.2024.101754","volume":"75","author":"M Mamo","year":"2024","unstructured":"Mamo M, Woldeyes E, Zegeye S, Feleke S, Melaku EE. Immediate and short-term outcomes of percutaneous balloon mitral commissurotomy for severe mitral stenosis at a Resource Limited Setting, Addis Ababa, Ethiopia. Prog Pediatr Cardiol. 2024;75:101754.","journal-title":"Prog Pediatr Cardiol"},{"key":"5770_CR20","doi-asserted-by":"crossref","unstructured":"Berhanu H, Mekonnen Y, Workicho A, Hassen K, Negeri Z, Sudhakar M et al. The prevalence of rheumatic heart disease in Ethiopia: a systematic review and meta-analysis. Tropical Diseases, Travel Medicine and Vaccines. 2023;9(1):16.","DOI":"10.1186\/s40794-023-00192-y"},{"key":"5770_CR21","doi-asserted-by":"publisher","first-page":"S338","DOI":"10.1016\/j.ihj.2018.09.005","volume":"70","author":"KKM Nair","year":"2018","unstructured":"Nair KKM, Valaparambil A, Sasidharan B, Ganapathi S, Gopalakrishnan A, Namboodiri N, et al. Immediate and late clinical outcomes of balloon mitral valvotomy based on immediate postballoon mitral valvotomy mitral valve area & percentage gain in mitral valve area\u2014a tertiary centre study. Indian Heart J. 2018;70:S338\u201346.","journal-title":"Indian Heart J"},{"key":"5770_CR22","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1016\/B978-0-323-80915-3.00027-2","volume-title":"Practical Cardiology","author":"F Noohi","year":"2022","unstructured":"Noohi F, Sadeghpour A, Alizadehasl A. Chapter 30 - Valvular Heart Disease. In: Maleki M, Alizadehasl A, Haghjoo M, editors. Practical Cardiology. Second Edition): Elsevier; 2022. pp. 527\u201371."},{"issue":"5","key":"5770_CR23","doi-asserted-by":"publisher","first-page":"452","DOI":"10.70749\/ijbr.v3i5.1387","volume":"3","author":"H Zakria","year":"2025","unstructured":"Zakria H, Khan MN, Azhar A, Zahoor S, Amjad F, Khan FU. Assessment of Post-Procedural Mitral Regurgitation and Its Mechanisms Using 3D Transthoracic Echocardiography Following PMBC in Patients with Rheumatic Mitral Stenosis. Indus J Bioscience Res. 2025;3(5):452\u20134.","journal-title":"Indus J Bioscience Res"},{"issue":"1","key":"5770_CR24","first-page":"20","volume":"6","author":"CM Adhikari","year":"2016","unstructured":"Adhikari CM, Malla R, Rajbhandari R, Shakya U, Sharma P, Shrestha N, et al. Percutaneous transvenous mitral commissurotomy in juvenile mitral stenosis. Cardiovasc Diagn Ther. 2016;6(1):20\u20134.","journal-title":"Cardiovasc Diagn Ther"},{"issue":"1","key":"5770_CR25","doi-asserted-by":"publisher","first-page":"16","DOI":"10.5830\/CVJA-2022-068","volume":"35","author":"RK Mutagaywa","year":"2024","unstructured":"Mutagaywa RK, Cramer MJ, Chillo P, Barongo A, Kifai E, Chamuleau S, et al. Characteristics and immediate outcomes of patients who underwent percutaneous balloon mitral valvuloplasty at the Jakaya Kikwete Cardiac Institute, Tanzania. Cardiovasc J Afr. 2024;35(1):16\u201326.","journal-title":"Cardiovasc J Afr"},{"issue":"5","key":"5770_CR26","first-page":"287","volume":"32","author":"AA Suliman","year":"2021","unstructured":"Suliman AA, Ngunga M, Jeilan M, Mohammed M, Mohamed M. Enhancing cardiovascular skills development in Africa: Khartoum first PTMC workshop. Cardiovasc J Afr. 2021;32(5):287\u20138.","journal-title":"Cardiovasc J Afr"},{"issue":"20","key":"5770_CR27","doi-asserted-by":"publisher","first-page":"102624","DOI":"10.1016\/j.jaccas.2024.102624","volume":"29","author":"RK Mutagaywa","year":"2024","unstructured":"Mutagaywa RK, Hamisi Mwinchete S, Calori JD, Albaghdadi M, Kajuna E, France P, et al. First Percutaneous Balloon Mitral Valvuloplasty in a Pregnant Patient in Tanzania. JACC Case Rep. 2024;29(20):102624.","journal-title":"JACC Case Rep"},{"key":"5770_CR28","doi-asserted-by":"publisher","first-page":"104867","DOI":"10.1016\/j.amsu.2022.104867","volume":"84","author":"S Yadav","year":"2022","unstructured":"Yadav S, Shah S, Gajurel RM, Poudel CM, Ghimire R, Shah N. A study of clinical profile and in hospital outcomes of patients undergoing percutaneous transvenous mitral commissurotomy at a tertiary care center of Nepal. Annals Med Surg. 2022;84:104867.","journal-title":"Annals Med Surg"},{"key":"5770_CR29","doi-asserted-by":"crossref","unstructured":"Rosenzweig EB, Abman SH, Adatia I, Beghetti M, Bonnet D, Haworth S et al. Paediatric pulmonary arterial hypertension: updates on definition, classification, diagnostics and management. Eur Respir J. 2019;53(1):1801916.","DOI":"10.1183\/13993003.01916-2018"},{"issue":"3","key":"5770_CR30","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s12055-023-01654-w","volume":"40","author":"VKA Rajan","year":"2024","unstructured":"Rajan VKA, Chandran S, Kaskar A, Rao R, Mehra S. Surgical rescue mitral valve procedure post percutaneous transluminal mitral commissurotomy-a single-center observational study. Indian J Thorac Cardiovasc Surg. 2024;40(3):327\u201331.","journal-title":"Indian J Thorac Cardiovasc Surg"},{"issue":"6","key":"5770_CR31","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1002\/clc.20902","volume":"34","author":"N Aslanabadi","year":"2011","unstructured":"Aslanabadi N, Golmohammadi A, Sohrabi B, Kazemi B. Repeat percutaneous balloon mitral valvotomy vs. mitral valve replacement in patients with restenosis after previous balloon mitral valvotomy and unfavorable valve characteristics. Clin Cardiol. 2011;34(6):401\u20136.","journal-title":"Clin Cardiol"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-026-05770-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-05770-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-05770-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:48:27Z","timestamp":1781642907000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12872-026-05770-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5770"],"URL":"https:\/\/doi.org\/10.1186\/s12872-026-05770-4","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"assertion":[{"value":"29 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The children heart fund of Ethiopia Adhoch Research Review Committee approved this study (Ref: CHFE\/M. D\/18\/25). Written informed consent was obtained from the parents or guardians of all participants before the PMBC procedure, and patients aged 7 years and older provided assent. All procedures complied with relevant guidelines and adhered to the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"385"}}