Author + information
- Ivana Picone Borges Aragao1,
- Edison Carvalho Sandoval Peixoto1,
- Rodrigo Trajano Sandoval Peixoto1,
- Ricardo Trajano Sandoval Peixoto1,
- Livia Liberata Barbosa Bandeira2,
- Ivan Lucas Picone Borges Anjos3,
- Caio Teixeira Santos2,
- Sandra Maria Barroso Werneck Vilagra2,
- Henrik Werneck Vilagra2,
- Marlon Mohamud Vilagra2,
- Vanessa Freitas Marcolla1,
- Patricia Rangel Sobral Dantas2,
- Eucir Rabello2 and
- Alexandre Augustus Brito Aragao1
Percutaneous mitral balloon valvotomy (PMBV) has emerged as an alternative to surgical treatment of mitral stenosis about 30 years ago.
To dentify the independents predictors of death and combined events (death, new mitral balloon valvotomy, or mitral valve surgery) in long-term follow-up of patients undergoing PMBV.
From 1987 to 2013 a total of 317 patientes were followed-up 156 ± 144(1987 e 2013) months. The techniques were the single-balloon (84.4%), Inoue-balloon (13.8%), and double-balloon techniques (1.7%). The total group was divided in two: echocardiographic score >8 and ≤ 8 points groups. Multivariate Cox regression analyses were performed to identify independent risk factors of long-term survival and event-free survival.
The mean age was 38.0±12.6 years old (range, 13 to 83). Before the procedure, 84,42% patients had echo score ≤ 8, and 15.57% score> 8. Females comprised 85%, and 84% patients were in sinus rhythm. During follow-up, survival of the total group was 95.5%, echo score group ≤ 8 was 98.0% and echo score > 8 was 82.2% (p<0.0001), whereas combined event-free survival was 83.4%, 86.1%, and 68.9%, respectively. The predictors of combined events were a previous history of mitral valvular commissurotomy, atrial fibrillation, the presence of severe mitral valve regurgitation during the procedure and post-procedure mitral valve area < 1.5 m2.
PMBV is an effective procedure. Survival was high, even higher in the group with lower echocardiographic scores. Over 2/3 of the patients were event-free at the end of follow-up. Independents predictors of survival were pre-procedure echo score ≤ 8 and the absence of severe mitral valve regurgitation during the procedure.