Comparison of the inoue and single balloon techniques during long term percutaneous balloon mitral valvoplasty follow-up. Analysis of risk factors for death and major events.

Objective: To analyze the long term evolution of patients undergoing percutaneous balloon mitral valvoplasty comparing the Inoue and Balt single balloon methods, and to identify predictors of death and major events (death, repeat balloon mitral valvoplasty or mitral valve surgery).

Methods: The follow-up for the single and Inoue balloon groups were 54 +/- 31 (1 to 126) months and 34 +/- 26 (2 to 105) months, respectively (p < 0.0001). The Balt single balloon was used in 254 (84.1%) patients and the Inoue balloon in 48 (15.9%).

Results: The following data were found for the Inoue and single balloon groups, respectively: age, 36.9 +/- 10.4 (19 to 63) years and 38.0 +/- 12.6 (13 to 83) years (p = 0.5769); echocardiographic score, 7.5 +/- 1.3 points and 7.2 +/- 1.5 points (p = 0.1307); female gender, 72.9% and 87.4% (p = 0.0097); atrial fibrillation, 10.4% and 16.1% (p = 0.4275); mortality during follow-up, 2.1% and 4.3% (0.6984); and major events, 8.3% and 17.7% (p = 0.1642). Univariate and Kaplan-Meier curve analyses revealed no differences between the Inoue and Balt single balloon techniques in relation to survival and major event free survival. In the multivariate analysis, age > 50 years and an echocardiographic score > 8 were independent predictors of death; and an echocardiographic score > 8 and post operative mitral valve area < 1.50 cm(2) were predictors for major events.

Conclusion: No differences were found in the long term evolution of patients undergoing the Inoue versus the single balloon technique. Predictors of death and/or major events were: age > 50 years, echocardiographic score > 8 and mitral valve area < 1.50 cm(2) after the procedure.