Long term outcome of percutaneous mitral balloon valvotomy in patients aged 70 and over.
OBJECTIVE
To assess the immediate haemodynamic improvement and long term symptomatic benefit of percutaneous mitral balloon valvotomy in patients aged over 70 years.


METHODS
Pre- and postprocedure haemodynamic data and follow up for 1 to 10 years by clinic visit or telephone contact.


METHODS
Tertiary referral centre in Scotland.


METHODS
80 patients age 70 and over who had mitral balloon dilatation: 55 were considered unsuitable for surgical treatment because of frailty or associated disease. In an additional four patients mitral dilatation was not achieved.


METHODS
Increase in valve area after balloon dilatation and survival, freedom from valve replacement, and symptom class at follow up.


RESULTS
Mean (SD) valve area increased by 89% from 0.84 (0.28) to 1. 59 (0.67) cm(2). There was a low rate of serious complications, with only two patients having long term major sequelae. Of 55 patients unsuitable for surgical treatment, 28 (51%) were alive without valve replacement and with improvement by at least one symptom class at one year, and 14 (25%) at five years. In the 25 patients considered suitable for surgical treatment, 16 (64%) achieved this outcome at one year and nine (36%) at five years.


CONCLUSIONS
Percutaneous mitral balloon valvotomy is a safe and useful palliative procedure in elderly patients who are unsuitable for surgery. Balloon dilatation should also be used for elderly patients whose valve appears suitable for improvement by commissurotomy, but echo score is an imperfect predictor of haemodynamic improvement.
Sutaria
N
N
Department of Cardiology, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.
Elder
A T
AT
Shaw
T R
TR
D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects; D000075202:Contraindications; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome