title: Initial Results and Long-Term Follow-up of Percutaneous Mitral Valvuloplasty in Patients with Pulmonary Hypertension.
abstract: BACKGROUND
  Percutaneous balloon mitral valvuloplasty (PMV) is an attractive therapeutic approach in patients with mitral stenosis. The aim of this study was to assess the immediate and long-term clinical, echocardiographic and haemodynamic outcomes of PMV in patients with severe pulmonary hypertension (PAH).
  
  
  METHODS
  Percutaneous balloon mitral valvuloplasty was performed in 157 consecutive patients; 60 patients (38.2%) had significant PAH defined as baseline pulmonary artery mean pressure (PAMP) ≥ 30mm Hg (Group 1) and 97 patients (61.8%) had PAMP ≤ 30mmHg (Group 2). Pulmonary artery systolic pressure (PASP), mortality, need for mitral valve replacement or new PMV, and valve restenosis were evaluated during follow-up.
  
  
  RESULTS
  Mean age was 44.2 years and 88.5% (139 patients) were women. Primary success was achieved in 79.6% of the patients (125 patients) without differences between the groups. Mitral valve area increased from 0.90cm2to 1.76cm2, PASP fell from 57mmHg to 35mmHg in Group 1 and from 38mmHg to 30mmHg in Group 2. Median PASP in Group 1 was 35, 32, 36, 38 and 34mmHg at 12, 24, 36, 48 and 60 months. There were no significant differences in mitral valve area, PASP and clinical status between the groups.
  
  
  CONCLUSIONS
  Percutaneous balloon mitral valvuloplasty is a safe and effective technique for the treatment of patients with mitral stenosis and PAH. A significant decrease in pulmonary pressure was observed after valvuloplasty. Although there was a gradual decrease of MVA at long-term follow-up, most patients remained asymptomatic and PASP was stable.
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina; Hospital El Cruce de Alta Complejidad en Red Dr. Néstor Kirchner, Florencio Varela, Provincia de Buenos Aires, Argentina.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Sarmiento
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina; Servicio de Hemodinamia. Cardiovascular Chivilcoy. Sanatorio Chivilcoy. Chivilcoy, Provincia de Buenos Aires, Argentina.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Blanco
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gigena
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lax
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina; Servicio de Hemodinamia. Cardiovascular Chivilcoy. Sanatorio Chivilcoy. Chivilcoy, Provincia de Buenos Aires, Argentina.
authors.forename: Alejandro Garcia
authors.initials: AG
authors.lastname: Escudero
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina; Servicio de Hemodinamia. Cardiovascular Chivilcoy. Sanatorio Chivilcoy. Chivilcoy, Provincia de Buenos Aires, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Blanco
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Szarfer
authors.affiliation: Hospital El Cruce de Alta Complejidad en Red Dr. Néstor Kirchner, Florencio Varela, Provincia de Buenos Aires, Argentina.
authors.forename: Raul
authors.initials: R
authors.lastname: Solerno
authors.affiliation: Hospital El Cruce de Alta Complejidad en Red Dr. Néstor Kirchner, Florencio Varela, Provincia de Buenos Aires, Argentina.
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Tajer
authors.affiliation: Sección Hemodinamia, División Cardiología. Hospital General de Agudos Dr. Cosme Argerich. Buenos Aires, Argentina. Electronic address: jgagliardi@intramed.net.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Gagliardi
mesh_terms: D000328:Adult; D063126:Balloon Valvuloplasty; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology* / Q000601:surgery*; D013997:Time Factors
keywords: Haemodynamics; Mitral valve stenosis; Pulmonary hypertension; Valvuloplasty