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Long-term results (up to 16.5 years) of mitral balloon valvuloplasty in a series of 518 patients and predictors of long-term outcome. | LitMetric

AI Article Synopsis

  • The study evaluates the long-term outcomes of mitral balloon valvuloplasty (MBV) in 518 patients with severe mitral stenosis, tracking results for up to 16.5 years.
  • After MBV, patients showed significant improvements in mitral valve area, but 21% experienced restenosis over time, with better outcomes observed in those with lower echocardiographic scores.
  • Key predictors for restenosis and overall event-free survival included echocardiographic score, post-procedure valve area, and pre-procedure functional class, indicating that patient selection and monitoring are crucial for positive long-term results.

Article Abstract

Objectives: To assess the long-term results (up to 16.5 years) of mitral balloon valvuloplasty (MBV) and to identify predictors of restenosis and event-free survival.

Methods And Results: We report the immediate and long-term clinical and echocardiographic results in 518 patients, mean age 31 +/- 11 years, who underwent successful MBV for severe mitral stenosis (MS) and were followed up for 0.5-16.5 (mean 6 +/- 4.5) years. After MBV, mitral valve area (MVA) increased from 0.84 +/- 0.2 to 1.83 +/- 0.53 cm(2) (P < 0.0001) as measured by catheter and from 0.92 +/- 0.17 to 1.96 +/- 0.29 cm(2) (P < 0.0001) as measured by two-dimensional echo. Restenosis occurred in 111 patients (21%) and it was less frequent in patients with low echo score (11%). Actuarial freedom from restenosis at 5, 10, 15 years was 85 +/- 1%, 70 +/- 3%, and 44 +/- 5%, respectively, and was significantly higher in patients with low echo score. Event-free survival (death, redo MBV, mitral valve replacement, New York Heart Association [NYHA] functional class III or IV) at 5, 10, 15 years was 89 +/- 1%, 79 +/- 2%, 43 +/- 9%, respectively, and was significantly higher for patients with low echo score. Cox regression analysis identified mitral echocardiographic score (MES) > 8 (P < 0.0001), postprocedure mitral valve area (MVA) (P = 0.0015), and preprocedure functional class (P = 0.014) as predictors of restenosis and MES (P < 0.0001) and age (P < 0.0001) and postprocedure MVA (P = 0.015) as predictors of event-free survival.

Conclusions: MBV provides excellent long-term results for selected patients with MS. The long-term outcome after this procedure can be predicted from baseline clinical and echocardiographic characteristics.

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Source
http://dx.doi.org/10.1111/j.1540-8183.2007.00212.xDOI Listing

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