Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome.
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.
Fawzy
Mohamed Eid
ME
Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia. fawzy100@hotmail.com
Hegazy
Hesham
H
Shoukri
Mohamed
M
El Shaer
Fayez
F
ElDali
Abdulmoneim
A
Al-Amri
Mohammed
M
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