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Percutaneous mitral balloon valvotomy (PMBV) has emerged as an alternative to surgical treatment of mitral stenosis.
To identify 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 2011 a total of 312 patients were followed-up 54.0±31.0 (1 to 126) 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 analysis was 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 (p<0.0001). In multivariate analysis, independent risk factors of death were pre procedure echo score > 8 and the presence of severe mitral valve regurgitation during the procedure. 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.