Article Text

PDF
19 years clinical and echocardiographic follow-up results of mitral balloon valvuloplasty in 547 consecutive patients and predictors of long-term outcome
  1. ME Fawzy,
  2. H Al Sergani,
  3. B Fadel,
  4. M Kandeel,
  5. S Shah,
  6. A ElDali
  1. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

Abstract

Background and Aims Long-term echocardiographic follow-up studies of mitral balloon valvuloplasty (MBV) are scarce. The aim of this study was to assess the long-term results (up to 19 years) of MBV in 547 consecutive patients and to identify predictors of restenosis and event-free survival.

Methods The immediate and long- term clinical and echocardiographic results of 547 consecutive patients (mean age 31.5 ± 11 years), who underwent successful MBV for severe mitral stenosis and were followed up for a mean of 8.8 ± 5 years (range 1–19 years) after MBV are reported. Predictors of restenosis and event-free survival were estimated using multivariable Cox regression analysis.

Results Immediately after MBV, the mitral valve area (MVA) increased from 0.92 ± 0.17 cm2 to 1.95 ± 0.29 cm2 (p<0.0001. Restenosis occurred in 169 (31%) patients, and was less frequent in 20%, with mitral echo score (MES ⩽8). Actuarial freedom from restenosis at 10, 15 and 19 years was 77 ± 2%, 46 ± 3% and 18 ± 5%, respectively, and was significantly higher in patients with MES ⩽8 (88 ± 2%, 66 ± 4%, 30 ± 7%, respectively; p<0.001). Event-free survival (death, redo MBV, mitral valve replacement, NYHA functional class III or IV) at 10, 15 and 19 years was 88 ± 2%, 53 ± 4%, 20 ± 7%, respectively, and was significantly higher for patients with MES ⩽8 (92 ± 1%, 67 ± 4%, 38 ± 8%, respectively; p<0.001). Multivariable Cox regression analysis identified MES >8 (p<0.0001) immediate MVA <2.0 (p = 0.017) and pulmonary hypertension (p = 0.008) as predictors of restenosis, and MES >8 (p<0.0001) as a predictor of combined events.

Conclusions MBV provides excellent long-term results for up to 19 years for selected patients with mitral stenosis. The long-term outcome of this procedure can be predicted from baseline clinical and echocardiographic characteristics of the mitral valve.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.