Long‐Term Results (Up to 16.5 Years) of Mitral Balloon Valvuloplasty in a Series of 518 Patients and Predictors of Long‐Term Outcome

Fawzy, Mohamed; Fadel, Bahaa M.; Alsergani, Hani; Amri, Mohammed Al; Hassan, Walid; Abdulbaki, Khalid; Shoukri, Mohamed; Canver, Charles C.

doi:10.1111/j.1540-8183.2007.00212.x

Cited by 18 publications

(18 citation statements)

References 31 publications

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“…In the National Heart, Lung Blood Institute Balloon Valvotomy Registry of 736 patients, [15] the MVA by echocardiographic assessment was 1.09 6 0.29 cm 2 before the procedure and increased to 1.8 6 0.15 cm 2 after the procedure. In the author's series of 518 patients [14] the echocardiographic MVA was 0.92 6 0.17 cm 2 before the procedure, and increased to 2.0 6 0.29 cm 2 after the procedure. A significant inverse relationship was found between the echo score and post procedure MVA where mitral valve morphology was found to be a strong predictor of post procedure mitral opening [13][14][15][16].…”

Section: Immediate Hemodynamic Resultsmentioning

confidence: 96%

“…In the author's series of 518 patients [14] the echocardiographic MVA was 0.92 6 0.17 cm 2 before the procedure, and increased to 2.0 6 0.29 cm 2 after the procedure. A significant inverse relationship was found between the echo score and post procedure MVA where mitral valve morphology was found to be a strong predictor of post procedure mitral opening [13][14][15][16]. However, good results could also be obtained in cases with relatively high echo score.…”

Section: Immediate Hemodynamic Resultsmentioning

confidence: 96%

“…Transesophageal (TEE) echo should be performed before PMBV for patients with atrial fibrillation or prior history of systemic embolism or very obese patient where the left atrium was not properly visualized. We do not recommend TEE as routine procedure before PMBV [14].…”

Section: Echocardiographic Evaluationmentioning

confidence: 91%

“…When the reported rates of complications of PMBV are viewed in aggregate, complications appear to occur at approximately the following rates: mortality (0-0.5%), cerebrovascular accident (CVA) (0.5-1%), cardiac tamponade (0.7-1%), mitral regurgitation requiring surgery (0.9-2%), mitral regurgitation of some degree (15%), and atrial septal defect detected by color Doppler (20-22%) which, however, closes or decreases in size in most patients [12,[14][15][16][17][18][19].…”

Section: Complications Of Balloon Mitral Valvotomymentioning

confidence: 97%

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Percutaneous mitral balloon valvotomy

Fawzy

2007

Cathet Cardio Intervent

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Percutaneous mitral balloon valvotomy (PMBV) was introduced in 1984 by Inoue who developed the procedure as a logical extension of surgical closed commissurotomy. Since then, PMBV has emerged as the treatment of choice for severe pliable rheumatic mitral stenosis (MS). With increasing experience and better selection of patient, the immediate results of the procedure have improved and the rate of complications declined. When the reported complications of PMBV are viewed in aggregate, complications occur at approximately the following rates: mortality (0-0.5%), cerebral accident (0.5-1%), mitral regurgitation (MR) requiring surgery (1.6-3%). These complication rates compare favorably to those reported after surgical commissurotomy. Several randomized trials reported similar hemodynamic results with PMBV and surgical commissurotomy. Restenosis after PMBV ranges from 4 to 70% depending on the patient selection, valve morphology, and duration of follow up. Restenosis was encountered in 21% of the author's series at mean follow-up 6 +/- 4.5 years and the 10 and 15 years restenosis-free survival rates were (70 +/- 3)% and (44 +/- 5)%, respectively, and were significantly higher for patients with favorable mitral morphology (85 +/- 3% and 65 +/- 6%), respectively (P < 0.0001). The 10 and 15 years event-free survival rates were (79 +/- 2)% and (43 +/- 9)% and were significantly higher for patients with favorable mitral morphology (88 +/- 2)% and (66 +/- 6)%, respectively (P < 0.0001). The effect of PMBV on severe pulmonary hypertension, concomitant severe tricuspid regurgitation, left ventricular function, left atrial size, and atrial fibrillation are addressed in this review. In addition, the application of PMBV in specific clinical situations such as in children, during pregnancy and for restenosis is discussed.

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Section: Immediate Hemodynamic Resultsmentioning

confidence: 96%

Section: Immediate Hemodynamic Resultsmentioning

confidence: 96%

Section: Echocardiographic Evaluationmentioning

confidence: 91%

Section: Complications Of Balloon Mitral Valvotomymentioning

confidence: 97%

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Percutaneous mitral balloon valvotomy

Fawzy

2007

Cathet Cardio Intervent

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“…They found that favorable valve anatomy, age, and postprocedural mitral valve area were predictors of event-free survival. 42 Iung et al 43 reported an event-free survival (survival with freedom from repeat PMBV, mitral valve replacement, cardiac death, high NYHA class) rate of 61% at 10 years in Ͼ1000 patients (mean age 49Ϯ14 years) with successful PBMV. Although favorable long-term prognosis largely depends on immediate procedural success, the prediction of late prognosis includes multiple factors including old age, unfavorable valve anatomy, high NYHA class, atrial fibrillation, low valve area after PBMV, high gradient after PBMV, and Ͼgrade 2 mitral regurgitation after PBMV.…”

Section: Long-term Resultsmentioning

confidence: 99%