European Heart Journal Advance Access originally published online on April 8, 2005
European Heart Journal 2005 26(16):1647-1652; doi:10.1093/eurheartj/ehi226
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Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome
1Department of Cardiovascular Diseases (MBC-16), King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia
2Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospitaland Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia
Received 14 September 2004; revised 13 February 2005; accepted 17 February 2005; online publish-ahead-of-print 8 April 2005.
* Corresponding author. Tel: +966 1 474 7272; fax: +966 1 442 7482. E-mail address: fawzy100{at}hotmail.com
Aims To assess the long-term outcome of mitral balloon valvotomy (MBV) and identify predictors of restenosis- and event-free survival.
Methods and results We report the immediate and long-term clinical and echocardiographic results in 493 patients, mean age 31±11, who underwent successful MBV and were followed-up for 0.5–15 years (median 5±3) with clinical and echocardiographic examination. After MBV, mitral valve area increased from 0.84±0.2 to 1.83±0.53 cm2 (P<0.0001) as measured by catheter and from 0.92±0.17 to 1.96±0.29 cm2 as measured by two-dimensional echo. Restenosis occurred in 86/493 (17.4%) patients and it was less frequent in patients with low echo score. Actuarial freedom from restenosis at 5, 7, 10, and 13 years were 89±1, 81±2, 68±3, and 51±6%, respectively, and was significantly higher in patients with low echo score. Event-free survival (death, redo MBV, mitral valve replacement, New York Heart Association functional Class III or IV) at 5, 7, 10, and 13 years were 92±1, 87±2, 80±3, and 74±3%, respectively, and was significantly higher for patients with low echo score. Cox regression analysis identified mitral echocardiographic score (MES) >8 as predictors of restenosis (P=0.0004) and MES and age as predictors of event-free survival (P=0.0003 and 0.004, respectively).
Conclusion MBV has excellent long-term results for selected patients with mitral stenosis. The long-term outcome after this procedure can be predicted from baseline clinical and valvular characteristics.
Key Words: Rheumatic heart disease • Mitral valve • Valvuloplasty
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