title: Long-term (up to 18 years) clinical and echocardiographic results of mitral balloon valvuloplasty in 531 consecutive patients and predictors of outcome.
abstract: OBJECTIVE
  The study aim was to assess the long-term results (up to 18 years) of mitral balloon valvuloplasty (MBV) and to identify predictors of restenosis and event-free survival.
  
  
  METHODS
  The immediate and long-term results for 531 consecutive patients (mean age 31 +/- 11 years) who underwent successful MBV and were followed up for a mean of 8.5 +/- 4.8 years (range: 1.5-18 years) are reported.
  
  
  RESULTS
  The mitral valve area (MVA) increased from 0.92 +/- 0.17 to 1.95 +/- 0.29 cm(2) (p < 0.0001). Restenosis was 31 and 19% in patients with mitral echocardiographic score (MES) < or =8. Actuarial freedom from restenosis at 10, 15 and 18 years was 77 +/- 2, 46 +/- 3 and 18 +/- 4% and 86 +/- 2, 62 +/- 4 and 31 +/- 7% for MES < or =8, respectively (p < 0.001). Event-free survival (death, redo MBV, mitral valve replacement, NYHA class III or IV) at 10, 15 and 18 years was 88 +/- 1, 53 +/- 4, and 21 +/- 5% and 93 +/- 2, 65 +/- 5 and 38 +/- 8% for MES < or =8, respectively (p < 0.001). Multivariable Cox regression analysis identified MES >8 (p < 0.0001) and previous surgery (p = 0.043) as predictors of restenosis, and MES >8 (p < 0.0001) and baseline atrial fibrillation (p = 0.03) as predictors of combined events.
  
  
  CONCLUSIONS
  MBV provides excellent long-term results. The baseline clinical and MES characteristics are predictors of outcome.
authors.affiliation: King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, 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: Bahaa
authors.initials: B
authors.lastname: Fadel
authors.forename: Amr
authors.initials: A
authors.lastname: Badr
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Al Ghamdi
authors.forename: Charles
authors.initials: C
authors.lastname: Canver
mesh_terms: D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation / Q000401:mortality; D002305:Cardiac Tamponade / Q000401:mortality; D002404:Catheterization / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D023903:Coronary Restenosis / Q000401:mortality; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality; D016016:Proportional Hazards Models; D055815:Young Adult