title: Seventeen years' clinical and echocardiographic follow up of mitral balloon valvuloplasty in 520 patients, and predictors of long-term outcome.
abstract: OBJECTIVE
  Long-term echocardiographic follow up studies of mitral balloon valvuloplasty (MBV) are scarce. The study aim was to assess the long-term results (up to 17 years) of MBV and to identify predictors of restenosis and event-free survival.
  
  
  METHODS
  The immediate and long-term clinical and echocardiographic results for 520 consecutive patients (mean age 31 +/- 11 years) who underwent successful MBV for severe mitral stenosis (MS) and were followed up for a mean of 7.3 +/- 4.35 years (range: 1 to 17 years) after MBV, were reported.
  
  
  RESULTS
  Immediately after MBV, the mitral valve area (MVA) was increased from 0.92 +/- 0.17 to 1.96 +/- 0.29 cm2 (p < 0.0001). Restenosis occurred in 133 patients (25.6%), and was less frequent (16.7%) in patients with a low mitral echo score (MES < or = 8). Actuarial freedom from restenosis at 10, 15, and 17 years was 73 +/- 2%, 43 +/- 4%, and 23 +/- 6%, respectively, and was significantly higher in patients with MES < or = 8 (84 +/- 2%, 52 +/- 6%, and 36 +/- 9%, respectively; p < 0.001). Event-free survival (death, redo MBV, mitral valve replacement, NYHA class III or IV) at 10, 15, and 17 years was 82 +/- 2%, 45 +/- 5%, and 31 +/- 6% respectively, and was significantly higher for patients with MES < or = 8 (90 +/- 2%, 60 +/- 5%, and 51 +/- 8%, respectively; p < 0.001). Cox regression analysis identified MES > 8 (p < 0.0001) and post-procedure MVA (p = 0.044) as predictors of restenosis, and MES < or = 8 (p < 0.0001), age (p < 0.0001), and post-procedure MVA (p = 0.016) as predictors of event-free survival.
  
  
  CONCLUSIONS
  MBV provides excellent long-term results for selected patients with MS. The long-term outcome of this procedure can be predicted from the baseline clinical and echocardiographic characteristics of the mitral valve.
authors.affiliation: 'King Faisal Heart Institute, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. fawzy100@hotmail.com
authors.forename: Mohamed Eid
authors.initials: ME
authors.lastname: Fawzy
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shoukri
authors.forename: Jehad
authors.initials: J
authors.lastname: Al Buraiki
authors.forename: Walid
authors.initials: W
authors.lastname: Hassan
authors.forename: Hassan
authors.initials: H
authors.lastname: El Widaal
authors.forename: Suleiman
authors.initials: S
authors.lastname: Kharabsheh
authors.forename: Aly
authors.initials: A
authors.lastname: Al Sanei
authors.forename: Charles
authors.initials: C
authors.lastname: Canver
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000503:physiopathology* / Q000628:therapy*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D012044:Regression Analysis; D016896:Treatment Outcome