[Long-term results of percutaneous mitral valvuloplasty].
OBJECTIVE
The aim of this study was to assess the long-term results of percutaneous transvenous mitral commisurotomy in our institution, and to evaluate potential predictors of long-term event-free survival.


METHODS
Between 1990 and 1996, 204 patients underwent percutaneous transvenous mitral commisurotomy with an Inoue balloon. One hundred and thirty two patients were followed for up to 9 months. Mean time of follow-up was 2.6-1.5 years (7 days-5.7 years). End points were considered mitral surgery, death and functional class III-IV. Long-term event-free survival analysis was performed to determine independent predictors of event-free survival.


RESULTS
At the end of the study, 88% of patients were classified as New York Heart Association class I-II. Multivariate analysis revealed that independent predictors of major events were stiffness and thickening of the valve, presence of severe left atrial enlargement as factors pre-procedure; with suboptimal results and significant mitral regurgitation after percutaneous transvenous mitral commisurotomy.


CONCLUSIONS
Percutaneous transvenous mitral commisurotomy with Inoue balloon is a safe and effective technique. Good results are maintained at long-term follow-up and the best results are obtained in patients with flexible and thin valves, with mild or moderate enlargement of left auricle and in cases with optimal results and without severe mitral regurgitation as a complication of the procedure.
Servicio de Cardiología, Hospital Universitario La Fe, Valencia. anaosa@servitel.es
A
A
Osa
L
L
Almenar
A
A
Rincón de Arellano
S
S
Martí
I
I
Roldán
V
V
Mora
M
M
Palencia
F
F
Algarra
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002404:Catheterization / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D016019:Survival Analysis