Long-term results up to 19 years of mitral balloon valvuloplasty.
Clinical and echocardiographic data of 547 consecutive patients (mean age, 31.5 years) undergoing mitral balloon valvuloplasty with follow-up of 1.5-19 years, were analyzed. Immediately after valvuloplasty, mitral valve area increased significantly from 0.92 +/- 0.17 to 1.95 +/- 0.29 cm(2). Restenosis occurred in 169 (31%) patients; it was less common (20%) in those with a mitral echocardiographic score </=8. Actuarial freedom from restenosis at 10, 15, and 19 years was 78% +/- 2%, 52% +/- 3%, and 26 +/- 4%, respectively, and significantly higher in patients with echocardiographic scores </=8: 88% +/- 2%, 67% +/- 4%, and 40% +/- 6%, respectively. Event-free survival at 10, 15, and 19 years was 88% +/- 2%, 60% +/- 4%, and 28% +/- 7%, respectively, and significantly higher in patients with echocardiographic scores </=8: 92% +/- 1%, 70% +/- 4%, and 42% +/- 7%, respectively. Multivariate analysis identified echocardiographic score </=8 and post-procedure valve area </=1.8 as predictors of restenosis, and echocardiographic score>8 and preexisting atrial fibrillation as predictors of combined events. Valvuloplasty provides excellent results in selected patients with mitral stenosis. The long-term outcome can be predicted from the baseline characteristics of the mitral valve.
Fawzy
Mohamed Eid
ME
October 6 University, October 6 City, Cairo, Egypt. fawzy100@hotmail.com
D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications; D002404:Catheterization / Q000009:adverse effects / Q000401:mortality; D002648:Child; D018572:Disease-Free Survival; D018618:Echocardiography, Doppler, Color; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology; D008946:Mitral Valve Stenosis / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult