[National registry of percutaneous mitral commissurotomy. 8-year's experience].
From April 1986 to June 1994 we performed percutaneous transvenous mitral commissurotomy in 689 patients with rheumatic mitral stenosis in a multicenter study. Mean age was 40 +/- 11 years, of then 84.9% female, 2.7% to had previous surgical treatment and in 1.4% the procedure was performed during pregnancy. Inoue balloon was used in 89.4%, double balloon 9.7% and monoballoon 0.9%. Mitral valve area (MVA) increased from 0.93 +/- 0.20 to 1.85 +/- 0.37 cm2 (p < 0.001) and mean pulmonary artery pressure from 31.5 +/- 15.8 to 22.4 +/- 11.5 mmHg (p < 0.001), mean left atrial pressure decreased from 20.9 +/- 8.1 to 10.0 +/- 5.9 mmHg (p < 0.001), transvalvular gradient (TVG) from 15.4 +/- 6.4 to 3.4 +/- 3.1 mmHg (p < 0.001) and mean pulmonary artery pressure from 31.5 +/- 15.8 to 22.4 +/- 11.5 mmHg (p < 0.001). Complete procedure without mayor complications was achieved in 93.1%. Severe mitral regurgitation (MR) was present in 3.9%. Optimal result in 82.1%, suboptimal in 8.2% and failure in 9.7%. Major complications 4.7%. Mortality was 0.9%. Six months follow-up MVA decreased to 1.77 +/- 0.38 (p < 0.001) and no changes to 24 months (1.78 +/- 0.37 p ns). Twenty four months follow-up 93.3% are in NYHA class I. Only MVA (> 1 cm2) and good predilatation NYHA class were predictors of optimal results. Severe MR were more frecuently in patients with atrial fibrillation and with high score (> 8). Our results were similar the international experience. We conclude that the technique of PTMC is a safe and effective technique.
Ledesma Velasco
M
M
Departamento de Hemodinámica, Hospital de Cardiología Centro Médico Nacional Siglo XXI, México, D.F.
Treviño Treviño
A
A
Delgado Caro
G
G
Martínez Ríos
M A
MA
Murillo Márquez
H
H
Munayer Calderón
J
J
de Zatarain Rivero
R
R
Encarnación Muñoz
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002404:Catheterization / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000628:therapy*; D011247:Pregnancy; D012042:Registries; D016896:Treatment Outcome
Registro nacional de comisurotomía mitral percutánea. Experiencia de 8 años.