Predictors of surgery after percutaneous mitral valvuloplasty.
BACKGROUND
Percutaneous mitral valvuloplasty (PMV) is a minimally invasive treatment option for selected patients with mitral stenosis (MS). In general, the procedure is well-tolerated with a high success rate. However, relatively little is known about the predictors of surgical intervention after PMV.


METHODS
A retrospective analysis was performed on 243 patients undergoing PMV at a single institution over a 14 year period.


RESULTS
Fifty (21%) of 243 patients, comprising 44 women and 6 men and aged 55 +/- 14 years, underwent cardiac surgery at a median interval of 6 months (range, 0 to 130) after PMV. Nine (18%) underwent a procedure within 15 days, and 41 (82%) had a procedure more than 15 days after the valvuloplasty. After PMV, surgery-free survival was 85% at 1 year, 83% at 2 years, 81% at 3 years, 80% at 4 years, and 80% at 5 years.


CONCLUSIONS
The need for surgery after PMV is not uncommon. Independent predictors of surgery after PMV included severity of mitral regurgitation (p < 0.003) and a higher echo score (p < 0.039).
Zimmet
Adam D
AD
Cardiothoracic Surgery Unit, Monash Medical Center, Clayton, Victoria, Australia.
Almeida
Aubrey A
AA
Harper
Richard W
RW
Smolich
Joseph J
JJ
Goldstein
Jacob
J
Shardey
Gilbert C
GC
Smith
Julian A
JA
D000328:Adult; D000368:Aged; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery; D002404:Catheterization / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome