Clinical follow-up of patients undergoing percutaneous mitral balloon valvotomy.
BACKGROUND
This study is the clinical follow-up (20 +/- 12 months; range, 6 to 49 months) of 327 patients who had percutaneous mitral balloon valvotomy (PMV) at the Massachusetts General Hospital.


RESULTS
There were seven in-hospital deaths. Patients were divided into two groups according to their echocardiographic score; 211 patients had echocardiographic scores < or = 8 and 116, echocardiographic scores > 8. Patients with echocardiographic scores > 8 were older (64 +/- 11 versus 48 +/- 14 years, P < .01), and more had atrial fibrillation (65% versus 40%, P < .01), calcium under fluoroscopy (81% versus 29%, P < .01), and previous surgical commissurotomy (30% versus 16%, P < .01) than patients with echocardiographic scores < or = 8. With PMV, mitral valve area increased from 1.0 +/- 0.3 to 2.2 +/- 0.8 cm2 in patients with echocardiographic scores < or = 8 and from 0.8 +/- 1 to 1.7 +/- 0.7 cm2 in those with echocardiographic scores > 8. Rates of survival (98 +/- 2% versus 72 +/- 11%), survival with freedom from mitral valve replacement (91 +/- 4% versus 55 +/- 13%), and survival with freedom from combined events (79 +/- 10% versus 39 +/- 18%) at follow-up were greater in patients with echocardiographic scores < or = 8 (P < .00005). Cox regression analysis identified the echocardiographic score as the most important unfavorable intermediate long-term follow-up prediction factor after PMV.


CONCLUSIONS
The excellent intermediate long-term clinical follow-up of patients with echocardiographic score < or = 8 and no calcified mitral valves suggests that PMV may be the treatment of choice in this group of patients.
Palacios
I F
IF
Department of Medicine (Cardiac Unit), Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Tuzcu
M E
ME
Weyman
A E
AE
Newell
J B
JB
Block
P C
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D008946:Mitral Valve Stenosis / Q000401:mortality / Q000628:therapy*