Long-term (up to 18 years) clinical and echocardiographic results of mitral balloon valvuloplasty in 531 consecutive patients and predictors of outcome.
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.
Fawzy
Mohamed Eid
ME
King Faisal Heart Institute, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. fawzy100@hotmail.com
Shoukri
Mohamed
M
Fadel
Bahaa
B
Badr
Amr
A
Al Ghamdi
Abdulaziz
A
Canver
Charles
C
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