title: Percutaneous mitral balloon valvuloplasty beyond 65 years of age.
abstract: BACKGROUND
  The profile of subjects undergoing percutaneous mitral balloon valvuloplasty (PMBV) in developed countries has shifted toward the elderly. In the group of elderly patients long-term results after PMBV, as well prognostic factors that may improve patient selection for this procedure have not been fully elucidated. Aim of the study was to evaluate the safety and efficacy of PMBV for the treatment of mitral stenosis in patients older than 65.
  
  
  METHODS
  The studied group consists of 132 consecutive patients aged > 65, who underwent PMBV. All PMBV procedures were performed by the antegrade transvenous approach using the Inoue balloon system.
  
  
  RESULTS
  Procedural success, defined as mitral valve area ≥ 1.5 cm2 and mitral regurgitation £ 2+, was obtained in 105 (79.5%) patients. Mean follow-up was 6.25 ± 4.33 years. Echo score > 8 and higher mean mitral valve gradient were significant independent predictors of inadequate immediate result. Survival curves showed that for the whole studied group after PMBV the 3-, 5-, and 10-year overall survival rates were significantly better in patients with left atrium diameter £ 5.0 cm before intervention (95.4%, 91.3% and 80.5% vs. 89.6%, 69.5%, and 53.7%, respectively; p = 0.002). Survival free of mitral valve intervention or heart failure ≥ NYHA III was significantly better for patients with good immediate result and mean pulmonary artery pressure after PMBV < 25 mm Hg.
  
  
  CONCLUSIONS
  PMBV is safe and efficacious in elderly patients with symptomatic mitral stenosis. Long-term results are good and related mainly to the quality of the procedure.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Chmielak
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kłopotowski
authors.forename: Marcin
authors.initials: M
authors.lastname: Demkow
authors.forename: Marek
authors.initials: M
authors.lastname: Konka
authors.forename: Piotr
authors.initials: P
authors.lastname: Hoffman
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kukuła
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kruk
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.forename: Witold
authors.initials: W
authors.lastname: Rużyłło
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D063126:Balloon Valvuloplasty / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008946:Mitral Valve Stenosis / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome