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European Heart Journal Advance Access published online on April 8, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi226
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received September 14, 2004
Revised February 13, 2005
Accepted February 17, 2005

Clinical research

Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome

Mohamed Eid Fawzy 1*, Hesham Hegazy 1, Mohamed Shoukri 2, Fayez El Shaer 1, Abdulmoneim ElDali 2, and Mohammed Al-Amri 1

1 Department of Cardiovascular Diseases (MBC-16), King Faisal Specialist Hospital and Research Centre,PO Box 3354, Riyadh 11211, Saudi Arabia
2 Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospitaland Research Center, PO Box 3354, Riyadh 11211, Saudi Arabia

* To whom correspondence should be addressed.
Mohamed Eid Fawzy, E-mail: fawzy100{at}hotmail.com


  Abstract

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.

Keywords: Rheumatic heart disease; Mitral valve; Valvuloplasty.
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