Systematic comparison of the effectiveness of percutaneous mitral balloon valvotomy with surgical mitral commissurotomy

Hu, Xiang; Zhao, Qiang

doi:10.4414/smw.2011.13180

Cited by 7 publications

(2 citation statements)

References 25 publications

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“…5,6 Some studies comparing PTMC with surgical commissurotomy (SC) have shown that its incidence of complication in long-term follow-up was similar in both procedures. 7,8 The success and safety of the PTMC is dependent on patient selection. Some factors, such as patient age, functional class, previous commissurotomy, pre-procedure mitral valve area (MVA), and valve anatomy all predict the outcomes of this procedure.…”

Section: Introductionmentioning

confidence: 99%

“…9 Although the evidence is not convincing regarding the superiority of either PTMC or SC, because of the greater morbidity associated with open surgery, the PTMC is a preferred procedure in young patients with favorable valve morphology. 8 Patients with lower Wilkins score benefit more from the PTMC than surgery and have better clinical outcomes. 10 Although there is sufficient evidence to support PTMC in the lower Wilkins score (≤8), 10 there is not sufficient evidence to support PTMC in the higher Wilkins score (>8).…”

Section: Introductionmentioning

confidence: 99%

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Comparative outcomes of percutaneous transvenous mitral commissurotomy between low and high Wilkins score

Alidoosti,

Sattartabar,

Pourhoseini

et al. 2023

Asian Cardiovasc Thorac Ann

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Background Percutaneous transvenous mitral commissurotomy (PTMC) is one of the non-surgical methods for patients with significant mitral stenosis. It is less invasive, less complicating with better outcomes compared to surgery. The Wilkins score ≤8 is used to select patients for PTMC, but the results of several studies suggest that PTMC can also be successful in a higher Wilkins score. The aim of this study is to compare the outcomes of PTMC between two groups. Methods In this retrospective study, patients who underwent PTMC between April 2011 and December 2019 were included. Patients were divided into two groups based on Wilkins score: 196 patients (57.64%) with a Wilkins score ≤8 (group I) and 134 patients (39.4%) with a Wilkins score >8 (group II). Results There was no difference in demographic characteristics between two groups except for age ( p = 0.04). Pre and post-interventional echocardiographic and catheterization measurements including left atrial pressure, pulmonary artery pressure, mitral valve area, mitral valve mean, and peak gradient were measured, and there was no difference between the two groups ( p > 0.05). The most common complication was mitral regurgitation (MR). Serious complications such as stroke and arrhythmias were rare in both groups (<1%). There was no difference between MR, ASD (atrial septal defect) and serious complications between the two groups. Conclusion This study shows that the Wilkins score with a cutoff value of 8 is not suitable for patient selection and novel criteria including both mitral valve features and other variables affecting the PTMC outcomes is needed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative outcomes of percutaneous transvenous mitral commissurotomy between low and high Wilkins score

Alidoosti,

Sattartabar,

Pourhoseini

et al. 2023

Asian Cardiovasc Thorac Ann

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Mitral and tricuspid valve disease

Reid

Ray

2018

Medicine

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Percutaneous mitral commissurotomy versus surgical commissurotomy for rheumatic mitral stenosis: a systematic review and meta-analysis of randomised controlled trials

Singh

Mian

Devasenapathy

et al. 2020

Heart

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AimPatients with severe mitral stenosis (MS) and their clinicians typically choose percutaneous transvenous mitral commissurotomy (PTMC) over surgical commissurotomy (SC). However, the durability of PTMC relative to SC is uncertain. We compared the efficacy, safety and durability of PTMC with SC for the treatment of MS.MethodsWe searched EMBASE, MEDLINE and WHO ICTRP registers for randomised controlled trials (RCTs) comparing PTMC, and open and/or closed mitral commissurotomy. The principal outcomes were rate of re-intervention and symptomatic improvement as inferred from the surrogate measures of immediate postprocedural mitral valve area (MVA), MVA at ≥6 month follow-up, incidence of mitral regurgitation (MR) and restenosis. We calculated weighted mean differences (WMD) for continuous outcomes, relative risks (RR) for binary outcomes and pooled outcomes using random-effects models and assessed the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.ResultsSeven RCTs with 553 patients proved eligible. Pooled estimates showed no convincing difference in the risk of restenosis or re-intervention (15/100 fewer with PTMC, 95% CI (−20 to +8); quality of evidence: moderate) or in symptoms as inferred from immediate MVA (WMD 0.15, 95% CI (−0.18 to 0.48): very low), from the incidence of postprocedural severe MR (3/100 more with PTMC, 95% CI (−1 to +10): moderate) or from MVA at 30 months.ConclusionUntil data demonstrating convincing superiority of SC over PTMC become available, our results support the current practice of recommending PTMC to young patients with MS and favourable valve morphology, as it is associated with lower peri-procedural morbidity.PROSPERO registration numberPROSPERO 2017 (CRD42017079512).

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Systematic comparison of the effectiveness of percutaneous mitral balloon valvotomy with surgical mitral commissurotomy

Cited by 7 publications

References 25 publications

Comparative outcomes of percutaneous transvenous mitral commissurotomy between low and high Wilkins score

Comparative outcomes of percutaneous transvenous mitral commissurotomy between low and high Wilkins score

Mitral and tricuspid valve disease

Percutaneous mitral commissurotomy versus surgical commissurotomy for rheumatic mitral stenosis: a systematic review and meta-analysis of randomised controlled trials

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