The M-Heart percutaneous balloon mitral Valvuloplasty Registry: initial results and early follow-up. The M-Heart Group.
The initial results, complications and early follow-up of 74 patients undergoing percutaneous balloon mitral valvuloplasty in seven hospitals participating in a multicenter registry are reported. Seventy-four patients with a mean age of 53 years had 75 valvuloplasty procedures performed over a 2.5 year period. Eighty-nine percent of the attempted procedures were completed and resulted in an increase in mean mitral valve area from 1.0 +/- 0.04 to 2.0 +/- 0.1 cm2 (p less than 0.0001); the valve area increased greater than or equal to 50% of the baseline valve area in 73% of the patients. Major complications included procedure-related death (2.7%), cardiac tamponade (6.7%), systemic embolism (2.7%) and emergency surgery (6.7%). At a mean follow-up period of 14.6 months, the condition of the majority of patients had improved, and 89% of 55 patients treated only with valvuloplasty were in New York Heart Association functional class I or II. Thus, hemodynamic and clinical improvement can be obtained in the majority of patients with mitral stenosis treated with balloon valvuloplasty in multiple centers. However, suboptimal results and major complications occurred in a significant number of patients and may limit this procedure to use by experienced operators in hospitals with facilities for cardiac surgery.
Cardiovascular Section, Hospital of the University of Pennsylvania, Philadelphia 19104.
H C
HC
Herrmann
J P
JP
Kleaveland
J A
JA
Hill
M J
MJ
Cowley
J R
JR
Margolis
M A
MA
Nocero
A
A
Zalewski
C J
CJ
Pepine
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications / Q000401:mortality; D012008:Recurrence; D012042:Registries / Q000706:statistics & numerical data*; D012421:Rupture / Q000209:etiology / Q000401:mortality; D015996:Survival Rate