[Percutaneous mitral balloon valvotomy. Long-term outcome and assessment of risk factors for death and major events].
OBJECTIVE
To identify the factors that predict death and combined events, (death, new mitral balloon valvotomy, or mitral valve surgery) in long-term follow-up of patients undergoing percutaneous mitral balloon valvotomy.


METHODS
Follow-up was 49.0+/-31.0 (1 to 122) months. Techniques used were the single-balloon (84.4%), Inoue-balloon (13.8%), and double-balloon techniques (1.7%).


RESULTS
Included in the study were 289 patients 38.0+/-12.6 years of age (range, 13 to 83). Before the procedure, 244 patients had echocardiographic score < or = 8, and 45 patients had score > 8. Females comprised 85%, and 84% patients were in sinus rhythm. During follow-up, survival of the total group was 95.5%, that of the group with < or = 8 was 98.0%, finally that of the group with scores > 8 was 82.2% (P < 0.0001), whereas combined event-free survival was 83.4%, 86.1%, and 68.9%, respectively (P < 0.0001). In the multivariate analysis, the factors that predicted long-term death were a preprocedure echocardiographic score > 8 and the presence of severe valvular mitral regurgitation during the procedure. The events that predicted combined events were a previous history of mitral valvular commissurotomy and atrial fibrillation and the presence of severe mitral valvular regurgitation during the procedure, and postprocedure mitral valvular area < 1.5 m2 (failure).


CONCLUSIONS
Percutaneous mitral balloon valvotomy is an effective procedure, and over 2/3 of the patients were event-free at the end of follow-up. Survival in the group was high, even higher in the group with lower echocardiographic scores.
Borges
Ivana Picone
IP
Cinecor 4 Centenario, Rio de Janeiro, RJ.
Peixoto
Edison Carvalho Sandoval
EC
Peixoto
Rodrigo Trajano Sandoval
RT
Oliveira
Paulo Sergio de
PS
Netto
Mario Salles
MS
Labrunie
Pierre
P
Labrunie
Marta
M
Peixoto
Ricardo Trajano Sandoval
RT
Villela
Ronaldo de Amorim
Rde A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002404:Catheterization; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008946:Mitral Valve Stenosis / Q000401:mortality* / Q000628:therapy*; D014463:Ultrasonography