title: Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome.
abstract: OBJECTIVE
  To assess the long-term outcome of mitral balloon valvotomy (MBV) and identify predictors of restenosis- and event-free survival.
  
  
  RESULTS
  We report the immediate and long-term clinical and echocardiographic results in 493 patients, mean age 31+/-11, who underwent successful MBV and were followed-up for 0.5-15 years (median 5+/-3) with clinical and echocardiographic examination. After MBV, mitral valve area increased from 0.84+/-0.2 to 1.83+/-0.53 cm(2) (P<0.0001) as measured by catheter and from 0.92+/-0.17 to 1.96+/-0.29 cm(2) as measured by two-dimensional echo. Restenosis occurred in 86/493 (17.4%) patients and it was less frequent in patients with low echo score. Actuarial freedom from restenosis at 5, 7, 10, and 13 years were 89+/-1, 81+/-2, 68+/-3, and 51+/-6%, respectively, and was significantly higher in patients with low echo score. Event-free survival (death, redo MBV, mitral valve replacement, New York Heart Association functional Class III or IV) at 5, 7, 10, and 13 years were 92+/-1, 87+/-2, 80+/-3, and 74+/-3%, respectively, and was significantly higher for patients with low echo score. Cox regression analysis identified mitral echocardiographic score (MES) >8 as predictors of restenosis (P=0.0004) and MES and age as predictors of event-free survival (P=0.0003 and 0.004, respectively).
  
  
  CONCLUSIONS
  MBV has excellent long-term results for selected patients with mitral stenosis. The long-term outcome after this procedure can be predicted from baseline clinical and valvular characteristics.
authors.affiliation: Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia. fawzy100@hotmail.com
authors.forename: Mohamed Eid
authors.initials: ME
authors.lastname: Fawzy
authors.forename: Hesham
authors.initials: H
authors.lastname: Hegazy
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shoukri
authors.forename: Fayez
authors.initials: F
authors.lastname: El Shaer
authors.forename: Abdulmoneim
authors.initials: A
authors.lastname: ElDali
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Amri
mesh_terms: D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D015150:Echocardiography, Doppler / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000401:mortality / Q000628:therapy; D008297:Male; D008946:Mitral Valve Stenosis / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome