Article Text

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


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.

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