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Percutaneous valvuloplasty for mitral valve restenosis: Postballoon valvotomy patients fare better than postsurgical closed valvotomy patients
Author(s) -
Nair Krishnakumar,
Sivadasanpillai Harikrishnan,
Sivasubramonium P.,
Ramachandran Padmakumar,
Tharakan Jaganmohan A.,
Titus Thomas,
Ajit Kumar V.K.,
Sivasubramonian Sivasankaran,
Krishnamoorthy K. Mahadevan,
Dora Santosh
Publication year - 2010
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.22510
Subject(s) - medicine , mitral valvuloplasty , restenosis , cardiology , mitral regurgitation , percutaneous , mitral valve , mitral valve replacement , surgery , stent
Aim : To compare the results of percutaneous mitral valvuloplasty (BMV) for mitral restenosis in post‐BMV versus postclosed mitral valvotomy (CMV) patients. Methods and Results : Ninety‐two patients who underwent BMV for mitral restenosis were followed up prospectively. Of these, 28 patients had undergone previous percutaneous mitral valvuloplasty (PRIOR BMV) and 64 patients had undergone previous closed mitral valvotomy (PRIOR CMV). BMV for mitral restenosis was a success in 59% patients (57.1% PRIOR BMV, 59.3% PRIOR CMV, P = 1.0). Incidence of severe mitral regurgitation was 3.25%, all in the PRIOR CMV group. In univariate analysis, the major predictor of successful BMV for mitral restenosis was Wilkins score ( P = 0.004). At a follow up of 3.47 + 2.07 years, mitral valve area was similar between groups (1.45 ± 0.22, 1.46 ± 0.26, P = 0.35). The combined end points of mitral valve replacement (MVR), need for rerepeat BMV for mitral restenosis or death was higher in the PRIOR CMV group (31.2% PRIOR CMV, 7.1% PRIOR BMV, P = 0.027). Event‐free survival at follow up was lower in the PRIOR CMV group (69% PRIOR CMV, 92.8% PRIOR BMV) mainly due to the higher need for MVR (11 vs. 0 patients, P = 0.03). Conclusions : In conclusion, following BMV for mitral restenosis, patients with PRIOR BMV are found to have lesser event rates on follow‐up compared to patients with PRIOR CMV, though procedural success rates are similar. © 2010 Wiley‐Liss, Inc.