[Percutaneous mitral commisurotomy in patients aged 60 years and more].
Of 745 patients treated by balloon mitral commissurotomy (BMC) between February 1988 and December 2002, 45 were > or = 60-years old. Immediate and late outcomes in this group (group 1) were compared with those in the patients aged < 60-years (group 2). Baseline hemodynamic parameters were comparable in the two groups. Mitral surface area and hemodynamic parameters improved significantly after BMC in group 1: mean left atrial pressure fell from 18.76 +/- 6.18 to 10.65 +/- 4.38 mmHg (P < 0.001), mean transmitral gradient from 11.03 +/- 4.70 to 4.63 +/- 2.05 mmHg (p < 0.001) and mitral valve area from 0.99 +/- 0.22 to 1.88 +/- 0.41 cm2 (p < 0.001). Similar significant improvements were seen in group 2. The hemodynamic result was good in 69% of group 1 patients. Tamponade occurred in one patient. Mitral regurgitation grade I or II developed in 8 patients and remained stable in 13 patients. These complication rates were comparable to those seen in group 2. In the group 1, a good result was maintained in 60% of patients after 43 +/- 23 months of follow-up. Although restenosis was observed in 40% of patients, functional amelioration was obtained in most of cases. In the group 2, restenosis was observed in 25% of patients. The data from this study suggest that BMC is effective first therapy in patients aged > or = 60-years with symptomatic mitral stenosis.
Remadi
F
F
Service de cardiologie, CHU Sahloul, 4000 Sousse, Tunisie.
Boughzala
E
E
Neffati
E
E
Jenayeh
N
N
Zemni
J
J
Hergli
N
N
Ismail
A
A
Ben Saad
H
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D016279:Atrial Function, Left / Q000502:physiology; D021721:Balloon Occlusion; D001794:Blood Pressure / Q000502:physiology; D002305:Cardiac Tamponade / Q000209:etiology; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D008944:Mitral Valve Insufficiency / Q000209:etiology; D008946:Mitral Valve Stenosis / Q000628:therapy*; D010490:Pericardial Effusion / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome