title: Immediate and mid-term results of repeat percutaneous mitral commissurotomy for restenosis following earlier percutaneous mitral commissurotomy.
abstract: OBJECTIVE
  This study assessed the results of repeat percutaneous mitral commissurotomy for mitral restenosis following a first procedure.
  
  
  RESULTS
  Repeat balloon commissurotomy was performed in 53 patients who had symptomatic restenosis a mean of 6+/-2 years (2-11) after a successful first procedure; seven patients had mildly calcified valves. All patients had restenosis with a fusion of both commissures as assessed by echocardiography. A double-balloon was used in one case and the Inoue technique in 52. Complications were stroke in one patient and severe mitral regurgitation (Sellers grade 3) in two. Valve area increased from 1.03+/-0.22 to 1.82+/-0.21 cm(2)(P<0.0001) as assessed by planimetry. Good immediate results, defined as valve area >/=1.5 cm(2)with no regurgitation >2/4, were obtained in 48 patients (91%). The 5-year survival rate without operation and in NYHA class I or II was 69+/-11% in the whole population, and 76+/-11% in the 48 patients who had had good immediate results.
  
  
  CONCLUSIONS
  This study suggests that repeat balloon commissurotomy is a valid treatment for symptomatic restenosis after a first successful procedure. It gives good results in patients selected on the basis of favourable characteristics and the echocardiographic analysis of the mechanism of restenosis.
authors.affiliation: Service de Cardiologie, Hopital Tenon, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Iung
authors.forename: E
authors.initials: E
authors.lastname: Garbarz
authors.forename: P
authors.initials: P
authors.lastname: Michaud
authors.forename: O
authors.initials: O
authors.lastname: Fondard
authors.forename: S
authors.initials: S
authors.lastname: Helou
authors.forename: J
authors.initials: J
authors.lastname: Kamblock
authors.forename: P
authors.initials: P
authors.lastname: Berdah
authors.forename: P L
authors.initials: PL
authors.lastname: Michel
authors.forename: P
authors.initials: P
authors.lastname: Lionet
authors.forename: B
authors.initials: B
authors.lastname: Cormier
authors.forename: G
authors.initials: G
authors.lastname: Papouin
authors.forename: A
authors.initials: A
authors.lastname: Vahanian
mesh_terms: D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology; D008946:Mitral Valve Stenosis / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy; D012008:Recurrence; D020521:Stroke / Q000209:etiology; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome