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ORIGINAL ARTICLE
Year : 2007  |  Volume : 8  |  Issue : 4  |  Page : 130-141

18 years follow-up results of mitral balloon valvuloplasty in 531 consecutive patients and predictors of long-term outcome


1 King Faisal Heart Institute, Riyadh; and Biostatistics, Epidemiology & Scientific Computing Department, Research Centre, Riyadh, Saudi Arabia
2 Biostatistics, Epidemiology & Scientific Computing Department, Research Centre, Riyadh, Saudi Arabia
3 King Faisal Heart Institute, Riyadh, Saudi Arabia

Correspondence Address:
Mohamed Eid Fawzy
FRCP, FACC, FESC, King Faisal Heart Institute (MBC 16), King Faisal Specialist Hospital and Research Center, PO Box 3354 Riyadh 11211
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


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Background : Aim of the study: Long-term echocardiographic follow-up studies of mitral balloon valvuloplasty (MBV) are scarce. The study aim was to assess the long-term results (up to 18 years) of MBV and to identify predictors of restenosis and event-free survival. Methods : The immediate and long-term clinical and echocardiographic results for 531 consecutive patients (mean age 31 ± 11 years) who underwent successful MBV for severe mitral stenosis (MS) and were followed up for a mean of 8.5 ± 4.8 years (range: 1.5 to 18 years) after MBV are reported. Results : Immediately after MBV, the mitral valve area (MVA) was increased from 0.92 ± 0.17 cm2 to 1.95 ± 0.29 cm2 (p < 0.0001). Restenosis occurred in 165 patients (31%), and was less frequent (19%) in patients with a low mitral echo score (MES ≤ 8). Actuarial freedom from restenosis at 10, 15 and 18 years was 77 ± 2%, 46 ۱ 3% and 18 ± 4%, respectively, and was significantly higher in patients with MES ≤ 8 (86 ± 2%, 62 ۱ 4% and 31 ± 7%) than in those with MES > 8 (p < 0.001). Event-free survival (death, redo MBV, mitral valve replacement, NYHA class III or IV) at 10, 15 and 18 years was 88 ± 1%, 53 ± 4%, and 21 ± 5% respectively, and was significantly higher for patients with MES ≤ 8 (93 ± 2%, 65 ± 5% and 38 ± 8%, respectively; p < 0.001). Multivariable Cox regression analysis identified MES > 8 (p < 0.0001) and previous surgery (p = 0.043) as predictors of restenosis, and MES > 8 (p < 0.0001) and baseline atrial fibrillation (p = 0.03) as predictors of combined events. Conclusion : MBV provides excellent long-term results for selected patients with MS. The long-term outcome of this procedure can be predicted from the baseline clinical and echocardiographic characteristics of the mitral valve.


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