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The impact of mitral valve morphology on the long‐term outcome of mitral balloon valvuloplasty
Author(s) -
Fawzy Mohamed Eid,
Shoukri Mohamed,
Hassan Walid,
Nambiar Vijayaraghavan,
Stefadouros Miltiadis,
Canver, Charles C.
Publication year - 2007
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20936
Subject(s) - medicine , mitral valvuloplasty , cardiology , mitral valve , restenosis , balloon , balloon valvuloplasty , surgery , stent
Background : The effect of mitral valve morphology (MVM) on the long‐term results of mitral balloon valvuloplasty (MBV) is not well established. The aim of the study was to evaluate the impact of MVM on long‐term outcome of MBV. Methods : Five hundred and eighteen consecutive patients (mean age, 31 ± 11 years) who underwent successful MBV were followed up for 0.5–16.5 (mean, 6 ± 4.5) years. Patients were divided into two groups according to their mitral echo score (MES) before MBV: group A ( n = 340; MES ≤ 8) and group B ( n = 178; MES > 8). Results : We report the immediate and long‐term clinical and echocardiographic results of the above‐mentioned 518 consecutive patients. The mitral valve area was significantly larger in group A than in group B, both immediately after MBV (2.0 ± 0.3 vs. 1.82 ± 0.3 cm 2 , respectively; P < 0.0001) and also at the last follow‐up (1.8 ± 0.33 vs. 1.5 ± 0.33 cm 2 , respectively; P < 0.0001). Restenosis occurred in 38/340 (11%) in group A vs. 73/178 (41%) in group B ( P < 0.0001). Actuarial freedom from restenosis at 5, 10, 15 years were 92 ± 2%, 85 ± 3%, 65 ± 6% for group A vs. 72 ± 4%, 44 ± 5%, 9 ± 6% for group B ( P < 0.001). Event‐free survival rates at 5, 10, 15 years for group A were 93 ± 1%, 88 ± 2%, 66 ± 6% vs. 82 ± 3%, 59± 6%, 8 ± 7% for group B ( P < 0.0001). Stepwise Cox multivariate regression analysis identified MES, preprocedure functional class, and postprocedure mitral valve area ≤ 1.8 cm 2 , as predictors of restenosis ( P < 0.0001, P = 0.014, P = 0.0015, respectively); MES and age as predictors of event‐free survival ( P < 0.0001, P < 0.0001, respectively). Conclusion : MBV has excellent long‐term results in patients with favorable MVM. Favourable MVM is a strong predictor of good long‐term outcome. © 2006 Wiley‐Liss, Inc.