title: Natural history and predictors of moderate mitral regurgitation following balloon mitral valvuloplasty using Inoue balloon.
abstract: BACKGROUND
  We studied the predictors and natural history of moderate mitral regurgitation following valvuloplasty using Inoue balloon since it has not been well documented in a large series.
  
  
  METHODS
  Balloon mitral valvuloplasty was performed in 590 consecutive patients with severe mitral stenosis with mitral regurgitation of mild or lesser grade. Echocardiography and haemodynamics of patients who developed moderate mitral regurgitation were compared with those who did not. They were followed-up. Factors that predicted the development of moderate regurgitation were studied.
  
  
  RESULTS
  21 patients (3.5%) developed moderate regurgitation (identified by auscultation, haemodynamics, angiography and colour flow mapping). They were managed conservatively. At 3 months, regurgitation decreased in severity to mild grade in 12 patients. At 1 year, it was trivial in 5, mild in 11 and remained moderate in 5. There was progressive symptomatic improvement. No clinical, echocardiographic, hemodynamic or procedural variables could predict the development of moderate mitral regurgitation.
  
  
  CONCLUSIONS
  Patients with moderate regurgitation after mitral valvuloplasty show gradual improvement in regurgitation and symptoms. There were no factors-clinical, echocardiographic, hemodynamic or procedural-that predicted the occurrence of moderate MR after BMV.
authors.affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. saikm@sctimst.ker.nic.in
authors.forename: K M
authors.initials: KM
authors.lastname: Krishnamoorthy
authors.forename: S
authors.initials: S
authors.lastname: Radhakrishnan
authors.forename: S
authors.initials: S
authors.lastname: Shrivastava
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects*; D002648:Child; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D008946:Mitral Valve Stenosis / Q000628:therapy*; D011237:Predictive Value of Tests; D012044:Regression Analysis