Short-term follow-up results of percutaneous mitral balloon valvuloplasty: A single-center experience

Abstract

Objective: We sought to analyze short-term clinical, echocardiographic, and hemodynamic consequences of percutaneous mitral balloon valvuloplasty (PMBV) in the treatment of rheumatic mitral stenosis (MS) in our clinic. Methods:We retrospectively reviewed 53 patients (49 females, 5 males; mean age 38±11 years) who underwent PMBV for moderate or severe MS between January 2010 and October 2014. Procedural success was defined as the reaching a mitral valve area (MVA) >1.5 cm 2 and absence of grade 3 mitral regurgitation. Results:We were able to perform PMBV in 48 of 53 patients (91%) and all the procedures that were completed were successful. PMBV couldn't be performed in 3 patients due to inability to pass the mitral valve, 1 patient due to membranous obstructive vena cava and 1 patient due inability to perform septostomi. Two patients who underwent successful PMBV became symptomatic after an average of 14 months follow-up and mitral valve replacement was performed due to moderate-to-severe MS. Patients were followed for an average of 13 ± 8 months and atrial fibrillation development or embolic complications were not observed. Conclusion:Percutaneous mitral balloon valvuloplasty procedure is a safe and effective treatment approach with high success and low complication rates in experienced centers.Key words: Mitral stenosis, percutaneous mitral balloon valvuloplasty, echocardiography, mitral valve area ÖZET Amaç: Bu çalışmada kliniğimizdeki romatizmal mitral darlıklı (MD) erişkin hastalara uygulanan perkütan mitral balon valvüloplastinin (PMBV) erken dönem klinik, ekokardiyografik ve hemodinamik sonuçlarını değerlendirme-yi amaçladık.Yöntemler: Kliniğimizde Ocak 2010-Ekim 2014 tarihleri arasında orta ya da ciddi MD nedeniyle PMBV uygulanan 53 hasta (49 kadın, 5 erkek; ortalama yaş 38±11 yıl) geriye dönük olarak değerlendirildi. İşlem başarısı, işlem sonrası mitral kapak alanının (MKA) >1,5 cm 2 olması ve 3. derece mitral yetersizlik (MY) olmaması olarak kabul edildi. Bulgular:Toplam 53 hastadan 48'inde (%91) PMBV iş-lemi uygulanabildi ve tamamlanabilen tüm işlemler başarılı oldu. Hastalardan 3'üne kapak geçilememesi, 1'ine membranöz obstrüktif vena kava, 1'ine de septostomi yapılamaması nedeniyle PMBV uygulanamadı. Başarılı PMBV uygulanan 2 hastaya ortalama 14 ay sonra semptomatik orta-ciddi MD nedeniyle mitral kapak replasmanı yapıldı. Ortalama 13±8 ay boyunca izlenen hastalarda atrial fibrilasyon gelişmesi veya embolik komplikasyonlar izlenmedi.Sonuç: Perkütan mitral balon valvüloplasti işlemi deneyimli merkezlerde yüksek başarı ve düşük komplikasyon oranları ile etkin ve güvenli bir tedavi yaklaşımıdır.Anahtar kelimeler: Mitral darlık, perkütan mitral balon valvüloplasti, ekokardiyografi, mitral kapak alanı

Can percutaneous mitral balloon valvuloplasty reduce ongoing inflammation in patients with rheumatic mitral stenosis?

“…Percutaneous transluminal mitral valvuloplasty (PTMV) techniques and equipments have continued to evolve over the last two decades. With this expanded experience, there has been refinement in patient selection and a clearer understanding of the benefits, limitations, and long-term results of PTMV [2]. It has become the first choice of the treatment in symptomatic severe mitral stenosis and favorable valve morphology in the absence of left atrial thrombus or moderate-to-severe MR [2,3].…”