Skip Navigation

European Heart Journal 2000 21(20):1683-1689; doi:10.1053/euhj.1999.1992
Copyright © 2000 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
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 (8)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Iung, B
Right arrow Articles by Vahanian, A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Iung, B
Right arrow Articles by Vahanian, A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Immediate and mid-term results of repeat percutaneous mitral commissurotomy for restenosis following earlier percutaneous mitral commissurotomy

B Iunga,f1, E Garbarza, P Michauda, O Fondarda, S Heloua, J Kamblockb, P Berdaha, P.-L Michela, P Lionetb, B Cormiera, G Papouinb and A Vahaniana

a Service de Cardiologie, Hopital Tenon, Paris, France
b Service de Cardiologie, Centre Hospitalier Territorial, Papeete, Tahiti, Polynésie Française

Received October 12, 1999; accepted October 13, 1999

Abstract

Aims This study assessed the results of repeat percutaneous mitral commissurotomy for mitral restenosis following a first procedure.

Methods and Results Repeat balloon commissurotomy was performed in 53 patients who had symptomatic restenosis a mean of 6±2 years (2–11) after a successful first procedure; seven patients had mildly calcified valves. All patients had restenosis with a fusion of both commissures as assessed by echocardiography. A double-balloon was used in one case and the Inoue technique in 52. Complications were stroke in one patient and severe mitral regurgitation (Sellers grade 3) in two. Valve area increased from 1·03±0·22 to 1·82±0·21cm2(P<0·0001) as assessed by planimetry. Good immediate results, defined as valve area ≥1·5cm2with no regurgitation >2/4, were obtained in 48 patients (91%). The 5-year survival rate without operation and in NYHA class I or II was 69±11% in the whole population, and 76±11% in the 48 patients who had had good immediate results.

Conclusion This study suggests that repeat balloon commissurotomy is a valid treatment for symptomatic restenosis after a first successful procedure. It gives good results in patients selected on the basis of favourable characteristics and the echocardiographic analysis of the mechanism of restenosis.

Key Words: Mitral valve, valvuloplasty, mitral restenosis

f1 Correspondence: Dr Bernard Iung, Service de Cardiologie, Hopital Bi Chat, 46 rue Henri Huchard, 75018 Paris, France.

References

  1. Rediker DE, Block PC, Abascal VM, Palacios IF. Mitral balloon valvuloplasty for mitral restenosis after surgical commissurotomy. J Am Coll Cardiol. 1988;11:252–256[Abstract]
  2. Davidson CJ, Bashore TM, Mickel M, Davis K. Balloon mitral commissurotomy after previous surgical commissurotomy. Circulation. 1992;86:91–99[Abstract/Free Full Text]
  3. Serra A, Bonan R, Lefevre T. Balloon mitral commissurotomy for mitral restenosis after surgical commissurotomy. Am J Cardiol. 1993;71:1311–1315[CrossRef][Web of Science][Medline]
  4. Jang IK, Block PC, Newell JB, Tuzcu EM, Palacios IF. Percutaneous mitral balloon valvotomy for recurrent mitral stenosis after surgical commissurotomy. Am J Cardiol. 1995;75:601–605[CrossRef][Web of Science][Medline]
  5. Lau KW, Ding ZP, Gao W, Koh TH, Johan A. Percutaneous balloon mitral valvuloplasty in patients with mitral restenosis after previous surgical commissurotomy. A matched comparative study. Eur Heart J. 1996;17:1367–1372[Abstract/Free Full Text]
  6. Vahanian A, Michel PL, Cormier B. Results of percutaneous mitral commissurotomy in 200 patients. Am J Cardiol. 1989;63:847–852[CrossRef][Web of Science][Medline]
  7. Vahanian A, Cormier B, Iung B. Percutaneous transvenous mitral commissurotomy using the Inoue technique: International experience. Cathet Cardiovasc Diagn. 1994;Suppl 2:8–15[Medline]
  8. Iung B, Cormier B, Ducimetière P. Immediate results of percutaneous mitral commissurotomy: a predictive model on a series of 1514 patients. Circulation. 1996;94:2124–2130[Abstract/Free Full Text]
  9. Palacios I. What is the gold standard to measure mitral valve area post mitral balloon valvuloplasty? Cathet Cardiovasc Diagn. 1994;33:315–316[Web of Science][Medline]
  10. Cormier B, Vahanian A, Michel PL. Evaluation par échographie bidimensionnelle et Doppler des résultats de la valvuloplastie mitrale percutanée. Arch Mal Coeur. 1989;82:185–191
  11. Harken DE, Black H, Taylor WJ, Thrower WB, Ellis LB. Reoperation for mitral stenosis. A discussion of postoperative deterioration and methods of improving initial and secondary operations. Circulation. 1961;23:7–12[Abstract/Free Full Text]
  12. Ellis LB, Singh JB, Morales DD, Harken DE. Fifteen- to twenty-year study of one thousand patients undergoing closed mitral valvuloplasty. Circulation. 1973;48:357–364[Abstract/Free Full Text]
  13. John S, Bashi VV, Jairaj PS. Closed mitral valvotomy: early results and long-term follow-up of 3724 consecutive patients. Circulation. 1983;68:891–896[Abstract/Free Full Text]
  14. Seltzer A, Cohn KE. Natural history of mitral stenosis: a review. Circulation. 1972;45:878–890[Free Full Text]
  15. Iung B, Cormier B, Ducimetière P. Résultats à 5 ans de la commissurotomie mitrale percutanée à partir d'une série de 606 patients. Arch Mal Coeur. 1996;89:1591–1598
  16. Arora R, Singh Kalra G, Ramachandra Murty GD. Percutaneous transatrial mitral commissurotomy: immediate and intermediate results. J Am Coll Cardiol. 1994;23:1327–1332[Abstract]
  17. Ben Farhat M, Betbout F, Gamra H. Results of percutaneous double-balloon mitral commissurotomy in one medical center in Tunisia. Am J Cardiol. 1995;76:1266–1270[CrossRef][Web of Science][Medline]
  18. Palacios IF, Block PC, Wilkins GT, Weyman AE. Follow-up of patients undergoing percutaneous mitral valvotomy. Analysis of factors determining restenosis. Circulation. 1989;79:573–579[Abstract/Free Full Text]
  19. 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][Web of Science][Medline]
  20. Iung B, Garbarz E, Michaud P. Late results of percutaneous mitral commissurotomy in a series of 1024 patients. Analysis of late clinical deterioration: frequency, anatomical findings, and predictive factors. Circulation. 1999;99:3272–3278[Abstract/Free Full Text]
  21. Cohen DJ, Kuntz RE, Gordon SPF. Predictors of long-term outcome after percutaneous balloon mitral valvuloplasty. N Engl J Med. 1992;327:1329–1335[Abstract]
  22. Palacios IF, Tuzcu ME, Weyman AE, Newell JB, Block PC. Clinical follow-up of patients undergoing percutaneous mitral balloon valvotomy. Circulation. 1995;91:671–676[Abstract/Free Full Text]
  23. 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][Web of Science][Medline]
  24. Orrange SE, Kawanishi DT, Lopez BM, Curry SM, Rahimtoola SH. Actuarial outcome after catheter balloon commissurotomy in patients with mitral stenosis. Circulation. 1997;95:382–389[Abstract/Free Full Text]
  25. Pavlides GS, Nahhas GT, London J. Predictors of long-term event-free survival after percutaneous mitral valvuloplasty. Am J Cardiol. 1997;79:1370–1374[CrossRef][Web of Science][Medline]
  26. Aronstam EM, Geiger JP, Gillespie JT. Reoperation for mitral stenosis. J Thorac Cardiovascular Surg. 1968;55:783–785[Web of Science][Medline]
  27. Rutledge R, McIntosh CL, Morrow AG. Mitral valve replacement after closed mitral commissurotomy. Circulation. 1982;66:I-162–6
  28. Salerno TA, Neilson IR, Charrette EJP, Lynn RB. A 25-year experience with the closed method of treatment in 139 patients with mitral stenosis. Ann Thorac Surg. 1981;31:300–304[Abstract]
  29. Fraser K, Sugden BA. Second closed mitral valvotomy for recurrent mitral stenosis. Thorax. 1977;32:756–762
  30. John S, Perianayagam J, Abraham KA. Restenosis of the mitral valve: surgical considerations and results of operation. Ann Thorac Surg. 1978;25:316–321[Abstract]
  31. Peper WA, Lytle BW, Cosgrove DM, Goormastic M, Loop FD. Repeat mitral commissurotomy: long-term results. Circulation. 1987;76:III-97–101
  32. Hernandez R, Banuelos C, Alfonso F. Long-term clinical and echocardiographic follow-up after percutaneous mitral valvuloplasty with the Inoue balloon. Circulation. 1999;99:1580–1586[Abstract/Free Full Text]
  33. Circulation. 1992;85:2014–2024[Abstract/Free Full Text]
  34. Herrmann HC, Ramaswamy K, Isner JM. Factors influencing immediate results, complications, and short-term follow-up status after Inoue balloon mitral valvotomy: a North American multicenter study. Am Heart J. 1992;124:160–166[CrossRef][Web of Science][Medline]
  35. Circulation. 1992;85:448–461[Abstract/Free Full Text]
  36. Fatkin D, Roy P, Morgan JJ, Feneley MP. Percutaneous balloon mitral valvotomy with the Inoue single-balloon catheter: commissural morphology as a determinant of outcome. J Am Coll Cardiol. 1993;21:390–397[Abstract]
  37. Logan A, Lowther CP, Turner WD. Reoperation for mitral stenosis. Lancet. 1962;i:443–449
  38. Kay PH, Belcher P, Dawkins K, Lennox SC. Open mitral valvotomy: fourteen years' experience. Br Heart J. 1983;50:4–7[Abstract/Free Full Text]
  39. Dekker A, Black H, von Lichtenberg F. Mitral valve restenosis. A pathologic study. J Thorac Cardiovasc Surg. 1968;55:434–446[Web of Science][Medline]
  40. Nakano S, Kawashima Y, Hirose H. Reconsiderations of indications for open mitral commissurotomy based on pathologic features of the stenosed mitral valve. J Thorac Cardiovasc Surg. 1987;94:336–342[Abstract]

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
 CirculationHome page
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]

Home page
 CirculationHome page
A. Vahanian and I. F. Palacios
Percutaneous Approaches to Valvular Disease
Circulation, April 6, 2004; 109(13): 1572 - 1579.
[Full Text] [PDF]

Home page
 HeartHome page
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]

Home page
 Eur Heart JHome page
U. Zeymer and K.-L. Neuhaus
Percutaneous balloon valvuloplasty--the first line treatment for mitral stenosis and restenosis
Eur. Heart J., October 2, 2000; 21(20): 1643 - 1644.
[PDF]

This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
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 (8)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Iung, B
Right arrow Articles by Vahanian, A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Iung, B
Right arrow Articles by Vahanian, A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?