Skip Navigation

European Heart Journal 1999 20(7):519-526; doi:10.1053/euhj.1998.1338
Copyright © 1999 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (6)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Langerveld, J.
Right arrow Articles by Jaarsma, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Langerveld, J.
Right arrow Articles by Jaarsma, W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Predictors of clinical events or restenosis during follow-up after percutaneous mitral balloon valvotomy

J. Langerveld, H.W. Thijs Plokker, S.M.P.G. Ernst, J.C. Kelder and W. Jaarsmaf1

Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands

revised June 30, 1998; accepted September 30, 1998

Abstract

Aims The purpose of this study is to define predictors of events or restenosis during follow-up after percutaneous mitral balloon valvotomy.

Methods and Results Percutaneous mitral balloon valvotomy was attempted in 137 patients with severe mitral valve stenosis. In 127 patients follow-up was complete with a mean of 4·2±2·6 years. Events during follow-up were defined as death, mitral valve surgery or repeat percutaneous mitral balloon valvotomy. Restenosis was defined as a decrease in mitral valve area from ≥1·5cm2following percutaneous mitral balloon valvotomy to <1·5cm2.There was 80±4% event-free survival 4 years after percutaneous mitral balloon valvotomy. Multivariate analysis showed chronic atrial fibrillation at baseline (P=0·039, relative risk (RR)=2·5) and a high residual maximal gradient after percutaneous mitral balloon valvotomy (P=0·004, RR=2·0 per 5mmHg) to be independent predictors of an event during follow-up. The restenosis rate was 28·3% after 4 years. Chronic atrial fibrillation at baseline (P=0·0338, RR=2·2), a small mitral valve area after percutaneous mitral balloon valvotomy (P=0·0003, RR=0·8/0·1cm2) and a high residual maximal trans-mitral gradient (P=0·0252, RR=1·6/5mmHg) were all independent predictors of restenosis.

Conclusion Patients with chronic atrial fibrillation and a high maximal transmitral gradient after percutaneous mitral balloon valvotomy have a higher risk for events during follow-up. Restenosis is related to the presence of chronic atrial fibrillation at baseline and a suboptimal percutaneous mitral balloon valvotomy result.

Key Words: Mitral valve stenosis, valvuloplasty, echo-cardiography

f1 Correspondence : Dr Wybren Jaarsma, Department of Cardiololgy, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands.

References

  1. Inoue K, Owaki T, Nakamura T. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg. 1984;87:394–402[Abstract]
  2. Lock JE, Khalilullah M, Shrivastava S, Bahl V, Keane JF. Percutaneous catheter commissurotomy in rheumatic mitral stenosis. N Engl J Med. 1985;313:1515–1518[Abstract]
  3. Palacios I, Block PC, Brandi S. Percutaneous balloon valvotomy for patients with severe mitral stenosis. Circulation. 1987;75:778–784[Abstract/Free Full Text]
  4. Vahanian A, Michel PL, Cormier B. Results of percutaneous mitral commissurotomy in 200 patients. Am J Cardiol. 1989;63:847–852[CrossRef][ISI][Medline]
  5. Circulation. 1992;85:448–461[Abstract/Free Full Text]
  6. Palacios IF, Block PC, Wilkins GT, Weyman AE. Follow-up of patients undergoing percutaneous mitral balloon valvotomy. Analysis of factors determining restenosis. Circulation. 1989;79:573–579[Abstract/Free Full Text]
  7. Chen CR, Cheng TO, Chen JY, Zhou YL, Mei J, Ma TZ. Long-term results of percutaneous mitral valvuloplasty with the Inoue balloon catheter. Am J Cardiol. 1992;70:1445–1448[CrossRef][ISI][Medline]
  8. Desideri A, Vanderperren O, Serra A. Long-term (9 to 33 months) echocardiographic follow-up after successful percutaneous mitral commissurotomy. Am J Cardiol. 1992;69:1602–1606[CrossRef][ISI][Medline]
  9. Pan M, Medina A, Suarez de Lezo J. Factors determining late success after mitral balloon valvulotomy. Am J Cardiol. 1993;71:1181–1185[CrossRef][ISI][Medline]
  10. Dean LS, Mickel M, Bonan R. Four-year follow-up of patients undergoing percutaneous balloon mitral commissurotomy, a report from the national heart, lung, and blood institute balloon valvuloplasty registry. J Am Coll Cardiol. 1996;28:1452–1457[Abstract]
  11. Chen CR, Cheng TO, Chen JY, Huang YG, Huang T, Zhang B. Long-term results of percutaneous balloon mitral valvuloplasty for mitral stenosis: a follow-up study to 11 years in 202 patients. Cathet Cardiovasc Diagn. 1998;43:132–139[CrossRef][ISI][Medline]
  12. Abascal VM, Wilkins GT, Choong CY. Echocardiographic evaluation of mitral valve structure and function in patients followed for at least 6 months after percutaneous balloon mitral valvuloplasty. J Am Coll Cardiol. 1988;12:606–615[Abstract]
  13. Abascal VM, Wilkins GT, O’Shea JP. Prediction of successful outcome in 130 patients undergoing percutaneous balloon mitral valvotomy. Circulation. 1990;82:448–456[Abstract/Free Full Text]
  14. Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J. 1988;60:299–308[Abstract/Free Full Text]
  15. Hatle L, Angelsen B, Tromsdal A. Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound. Circulation. 1979;60:1096–1104[Abstract/Free Full Text]
  16. Inoue K. Percutaneous transvenous mitral commissurotomy using the Inoue balloon. Eur Heart J. 1991;12:99–108[Free Full Text]
  17. Reyes VP, Raju BS, Wynne J. Percutaneous balloon valvuloplasty compared with open surgical commissurotomy for mitral stenosis. N Engl J Med. 1994;331:961–967[Abstract/Free Full Text]
  18. Feldman T, Carroll JD, Herrmann HC. Three year follow-up after Inoue balloon mitral valvotomy (Abstract). J Am Coll Cardiol. 1994;:61A
  19. Pavlides GS, Nahhas GT, London J. Predictors of long-term event-free survival after percutaneous balloon mitral valvuloplasty. Am J Cardiol. 1997;79:1370–1374[CrossRef][ISI][Medline]
  20. Nobuyoshi M, Hamasaki N, Kimura T. Indications, complications, and short-term clinical outcome of percutaneous transvenous mitral commissurotomy. Circulation. 1989;80:782–792[Abstract/Free Full Text]
  21. Hung JS, Chern MS, Wu JJ. Short- and long-term results of catheter balloon percutaneous transvenous mitral commissurotomy. Am J Cardiol. 1991;67:854–862[CrossRef][ISI][Medline]
  22. Vahanian A, Michel PL, Cormier B. Immediate and mid-term results of percutaneous mitral commissurotomy. Eur Heart J. 1991;12:84–89
  23. Post JR, Feldman TED, Isner J, Herrmann HC. Inoue balloon mitral valvotomy in patients with severe valvular and subvalvular deformity. J Am Coll Cardiol. 1995;25:1129–1136[Abstract]
  24. Farhat MB, Ayari M, Maatouk F. Percutaneous balloon versus surgical closed and open mitral commissurotomy. Seven-year follow-up results of a randomised trial. Circulation. 1998;97:245–250[Abstract/Free Full Text]
  25. Thomas MR, Monaghan MJ, Michalis LK, Jewitt DE. Echocardiographic restenosis after successful balloon dilatation of the mitral valve with the Inoue balloon: experience of a United Kingdom centre. Br Heart J. 1993;69:418–423[Abstract/Free Full Text]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
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]

Home page
 EuropaceHome page
J. Langerveld, N. M. van Hemel, J. C. Kelder, J. M. P. G. Ernst, H. W. M. Plokker, and W. Jaarsma
Long-term follow-up of cardiac rhythm after percutaneous mitral balloon valvotomy: Does atrial fibrillation persist?
Europace, January 1, 2003; 5(1): 47 - 53.
[Abstract] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (6)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Langerveld, J.
Right arrow Articles by Jaarsma, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Langerveld, J.
Right arrow Articles by Jaarsma, W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?