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Circulation, Vol 79, 573-579, Copyright © 1989 by American Heart Association

ARTICLES

Follow-up of patients undergoing percutaneous mitral balloon valvotomy. Analysis of factors determining restenosis

IF Palacios, PC Block, GT Wilkins and AE Weyman
Cardiac Unit Department of Medicine, Massachusetts General Hospital, Boston 02114.

This study reports the clinical follow-up (13 +/- 1 months) of 100 consecutive patients who underwent percutaneous mitral balloon valvotomy (PMV). Echocardiographic (n = 32) and cardiac catheterization (n = 37) data from this group are also included. Patients were divided into two groups by an echocardiographic score. PMV resulted in a good hemodynamic result (post-PMV mitral valve area, greater than or equal to 1.5 cm2) in 88% of patients with a score of 8 or less and 44% of patients with a score of more than 8. Eighty-eight percent of patients with a score of 8 or less (n = 57) were New York Heart Association (NYHA) functional Classes III and IV before PMV; at follow-up, 81% were NYHA Class I and 12% were NYHA Class II. There were no deaths; three patients underwent mitral valve replacement (MVR). Ninety-eight percent of patients with a score of more than 8 (n = 43) were NYHA Classes III and IV before PMV; at follow-up, 58% were NYHA Classes I and II. Seven patients who did not improve and were not surgical candidates died 3.8 +/- 1.2 months after PMV. Nine patients who were surgical candidates underwent elective MVR at 4 +/- 0.9 months after PMV. Repeat cardiac catheterization demonstrated restenosis in only one of 27 patients (4%) with a score of 8 or less. Mitral valve area after PMV was 1.9 +/- 0.1 cm2 and at follow-up was 2 +/- 0.1 cm2 (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

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