(Circulation. 1999;99:1580-1586.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Long-Term Clinical and Echocardiographic Follow-Up After Percutaneous Mitral Valvuloplasty With the Inoue Balloon
From Unidad de Hemodinámica (R.H., C.B., F.A., J.G., A.F.-O., J.E., L.A., C.M.) and Servicio de Cardiologia (C.A.), Hospital Universitario San Carlos, Madrid, Spain.
Correspondence to Dr R. Hernandez, Unidad de Hemodinámica, Hospital Universitario San Carlos, C/Prof Martin Lagos s/n, Madrid 28040, Spain.
Background—The objective of this study was to assess the long-term clinical outcome and valvular changes (area and regurgitation) after percutaneous mitral valvuloplasty (PMV).
Methods and Results—After PMV, 561 patients were followed up for
39 (±23) months and clinical/echocardiographic data
obtained yearly. Kaplan-Meier and Cox regression analyses were
performed to estimate event-free survival, its predictors, and the
relative risks of several patient subgroups. There were several
nonexclusive events: 19 (3.3%) cardiac deaths, 55 (9.8%) mitral
replacements, 6 (1%) repeated PMVs, 56 (10%) cases of
restenosis, and 108 (19%) cases of clinical impairment.
Survival free of major events (cardiac death, mitral surgery, repeat
PMV, or functional impairment) was 69% at 7 years, ranging from 88%
to 40% in different subgroups of patients. Wilkins score was the best
preprocedural predictor of mitral opening, but the procedural result
(mitral area and regurgitation) was the only
independent predictor of major event-free survival. Mitral area loss,
though mild [0.13 (±0.21)cm2], increased with time and
was 
0.3 cm2 in 12%, 22%, and 27% of patients at 3, 5,
and 7 years, respectively. Regurgitation did not
progress in 81% of patients, and when it occurred it was usually by 1
grade.
Conclusions—Seven years after PMV, more than two thirds of patients were in good clinical condition and free of any major event. The procedural result was the main determinant of long-term outcome, although a high score had also negative implications. Mitral area decreased progressively over time, whereas regurgitation did not tend to progress.
Key Words: mitral valve • valvuloplasty • follow-up studies • restenosis • survival
This article has been cited by other articles:
 |
|
 |
|
  J.-K. Song, J.-M. Song, D.-H. Kang, S.-C. Yun, D. W. Park, S. W. Lee, Y.-H. Kim, C. W. Lee, M.-K. Hong, J.-J. Kim, et al. Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty: immediate post-procedural mitral valve area as an important prognosticator Eur. Heart J., May 2, 2009; 30(10): 1254 - 1262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Nobuyoshi, T. Arita, S.-i. Shirai, N. Hamasaki, H. Yokoi, M. Iwabuchi, H. Yasumoto, and H. Nosaka Percutaneous Balloon Mitral Valvuloplasty: A Review Circulation, March 3, 2009; 119(8): e211 - e219. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Messika-Zeitoun, J. Blanc, B. Iung, E. Brochet, B. Cormier, D. Himbert, and A. Vahanian Impact of degree of commissural opening after percutaneous mitral commissurotomy on long-term outcome. J. Am. Coll. Cardiol. Img., January 1, 2009; 2(1): 1 - 7. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, October 7, 2008; 118(15): e523 - e661. [Full Text] [PDF]
|
|
|
|
 |
|
 R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., September 23, 2008; 52(13): e1 - e142. [Full Text] [PDF]
|
|
|
|
|
|
M.-J. Kim, J.-K. Song, J.-M. Song, D.-H. Kang, Y.-H. Kim, C. W. Lee, M.-K. Hong, J.-J. Kim, S.-W. Park, and S.-J. Park Long-Term Outcomes of Significant Mitral Regurgitation After Percutaneous Mitral Valvuloplasty Circulation, December 19, 2006; 114(25): 2815 - 2822. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Zimmet, A. A. Almeida, R. W. Harper, J. J. Smolich, J. Goldstein, G. C. Shardey, and J. A. Smith Predictors of surgery after percutaneous mitral valvuloplasty. Ann. Thorac. Surg., September 1, 2006; 82(3): 828 - 833. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF]
|
|
|
|
|
|
M. E. Fawzy, H. Hegazy, M. Shoukri, F. El Shaer, A. ElDali, and M. Al-Amri Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome Eur. Heart J., August 2, 2005; 26(16): 1647 - 1652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Gomez-Hospital, A. Cequier, P. V. Romero, C. Canete, C. Ugartemendia, E. Iraculis, and E. Esplugas Persistence of Lung Function Abnormalities Despite Sustained Success of Percutaneous Mitral Valvotomy: The Need for an Early Indication Chest, January 1, 2005; 127(1): 40 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Vahanian and I. F. Palacios Percutaneous Approaches to Valvular Disease Circulation, April 6, 2004; 109(13): 1572 - 1579. [Full Text] [PDF]
|
|
|
|
|
|
H Gamra, F Betbout, K Ben Hamda, F Addad, F Maatouk, Z Dridi, S Hammami, M Abdellaoui, H Boughanmi, T Hendiri, et al. Balloon mitral commissurotomy in juvenile rheumatic mitral stenosis: a ten-year clinical and echocardiographic actuarial results Eur. Heart J., July 2, 2003; 24(14): 1349 - 1356. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B D Prendergast, T R D Shaw, B Iung, A Vahanian, and D B Northridge Contemporary criteria for the selection of patients for percutaneous balloon mitral valvuloplasty Heart, May 1, 2002; 87(5): 401 - 404. [Full Text] [PDF]
|
|
|
|
|
|
A. Wang, R. A. Krasuski, J. J. Warner, K. Pieper, K. B. Kisslo, T. M. Bashore, and J. K. Harrison Serial echocardiographic evaluation of restenosis after successful percutaneous mitral commissurotomy J. Am. Coll. Cardiol., January 16, 2002; 39(2): 328 - 334. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Yetkin, S. Cehreli, M. ileri, K. Senen, R. Atak, A. Yanik, O. Yetkin, and H. Sasmaz Comparison of Clinical Echocardiographic and Hemodynamic Characteristics of Male and Female Patients who Underwent Mitral Balloon Valvuloplasty Angiology, December 1, 2001; 52(12): 835 - 839. [Abstract] [PDF]
|
|
|
|
|
|
A. Vahanian VALVE DISEASE: Balloon valvuloplasty Heart, February 1, 2001; 85(2): 223 - 228. [Full Text]
|
|
|
|
|
|
B Iung, E Garbarz, P Michaud, O Fondard, S Helou, J Kamblock, P Berdah, P.-L Michel, P Lionet, B Cormier, et al. Immediate and mid-term results of repeat percutaneous mitral commissurotomy for restenosis following earlier percutaneous mitral commissurotomy Eur. Heart J., October 2, 2000; 21(20): 1683 - 1689. [Abstract] [PDF]
|
|
|
|
|
|
T. O. Cheng, R. Hernandez, C. Banuelos, F. Alfonso, J. Goicolea, A. Fernandez-Ortiz, J. Escaned, L. Azcona, C. Almeria, and C. Macaya Long-Term Results of Percutaneous Balloon Mitral Valvuloplasty Using the Inoue Balloon Catheter Technique • Response Circulation, February 29, 2000; 101 (8): e91 - e91. [Full Text] [PDF]
|
|
|
|
|
|
I. F. Palacios, P. L. Sanchez, L. C. Harrell, A. E. Weyman, and P. C. Block Which Patients Benefit From Percutaneous Mitral Balloon Valvuloplasty?: Prevalvuloplasty and Postvalvuloplasty Variables That Predict Long-Term Outcome Circulation, March 26, 2002; 105(12): 1465 - 1471. [Abstract] [Full Text] [PDF]
|
|