Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery

Jae Kwan Song, Mi Jeong Kim, Sung Cheol Yun, Suk Jung Choo, Jong Min Song, Hyun Song, Duk Hyun Kang, Cheol Hyun Chung, Duk Woo Park, Seung Whan Lee, Young Hak Kim, Cheol Whan Lee, Myeong Ki Hong, Jae Joong Kim, Jae Won Lee, Seong Wook Park, Seung Jung Park

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30 Citations (Scopus)

Abstract

Objectives: We sought to compare long-term outcomes between percutaneous mitral valvuloplasty and open heart surgery. Methods: The study evaluated 402 patients who underwent percutaneous mitral valvuloplasty and 159 patients who underwent open heart surgery between January 1, 1995, and December 31, 2000. The rates of cardiovascular death or repeated intervention (redo percutaneous mitral valvuloplasty or open heart surgery) were determined over a median follow-up of 109 months (mean ± SD, 106 ± 27). The therapeutic effects on adverse outcomes were estimated by the Cox proportional hazards model adjusting differences in the severity of illness before intervention. The effects of the cardiac rhythm and echocardiographic score were also tested. Results: The observed (unadjusted) event-free survival was similar for both groups, and the hazard ratio for the clinical events after percutaneous mitral valvuloplasty as compared with after open heart surgery was 1.510 (95% confidence interval, 0.914-2.496; P = .1079). However, the adjusted hazard ratio was 3.729 (95% confidence interval, 1.963-7.082; P < .0001), showing a higher event-free survival in the open heart surgery group. The adjusted hazard ratio after percutaneous mitral valvuloplasty as compared with after open heart surgery in patients with echocardiographic scores of 8 or more and atrial fibrillation were 5.348 (95% confidence interval, 2.504-11.422; P < .001) and 3.440 (95% confidence interval, 1.805-6.555; P = .0002), respectively, whereas the hazard ratio in patients with echocardiographic scores less than 8 and normal sinus rhythm did not show differences. Conclusions: Open heart surgery was associated with a higher adjusted rate of long-term event-free survival than percutaneous mitral valvuloplasty. Patients with high echocardiographic scores or atrial fibrillation showed better outcomes after open heart surgery.

Original languageEnglish
Pages (from-to)103-110
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume139
Issue number1
DOIs
Publication statusPublished - 2010 Jan 1

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Balloon Valvuloplasty
Thoracic Surgery
Confidence Intervals
Disease-Free Survival
Atrial Fibrillation
Therapeutic Uses
Proportional Hazards Models
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Song, Jae Kwan ; Kim, Mi Jeong ; Yun, Sung Cheol ; Choo, Suk Jung ; Song, Jong Min ; Song, Hyun ; Kang, Duk Hyun ; Chung, Cheol Hyun ; Park, Duk Woo ; Lee, Seung Whan ; Kim, Young Hak ; Lee, Cheol Whan ; Hong, Myeong Ki ; Kim, Jae Joong ; Lee, Jae Won ; Park, Seong Wook ; Park, Seung Jung. / Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery. In: Journal of Thoracic and Cardiovascular Surgery. 2010 ; Vol. 139, No. 1. pp. 103-110.
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abstract = "Objectives: We sought to compare long-term outcomes between percutaneous mitral valvuloplasty and open heart surgery. Methods: The study evaluated 402 patients who underwent percutaneous mitral valvuloplasty and 159 patients who underwent open heart surgery between January 1, 1995, and December 31, 2000. The rates of cardiovascular death or repeated intervention (redo percutaneous mitral valvuloplasty or open heart surgery) were determined over a median follow-up of 109 months (mean ± SD, 106 ± 27). The therapeutic effects on adverse outcomes were estimated by the Cox proportional hazards model adjusting differences in the severity of illness before intervention. The effects of the cardiac rhythm and echocardiographic score were also tested. Results: The observed (unadjusted) event-free survival was similar for both groups, and the hazard ratio for the clinical events after percutaneous mitral valvuloplasty as compared with after open heart surgery was 1.510 (95{\%} confidence interval, 0.914-2.496; P = .1079). However, the adjusted hazard ratio was 3.729 (95{\%} confidence interval, 1.963-7.082; P < .0001), showing a higher event-free survival in the open heart surgery group. The adjusted hazard ratio after percutaneous mitral valvuloplasty as compared with after open heart surgery in patients with echocardiographic scores of 8 or more and atrial fibrillation were 5.348 (95{\%} confidence interval, 2.504-11.422; P < .001) and 3.440 (95{\%} confidence interval, 1.805-6.555; P = .0002), respectively, whereas the hazard ratio in patients with echocardiographic scores less than 8 and normal sinus rhythm did not show differences. Conclusions: Open heart surgery was associated with a higher adjusted rate of long-term event-free survival than percutaneous mitral valvuloplasty. Patients with high echocardiographic scores or atrial fibrillation showed better outcomes after open heart surgery.",
author = "Song, {Jae Kwan} and Kim, {Mi Jeong} and Yun, {Sung Cheol} and Choo, {Suk Jung} and Song, {Jong Min} and Hyun Song and Kang, {Duk Hyun} and Chung, {Cheol Hyun} and Park, {Duk Woo} and Lee, {Seung Whan} and Kim, {Young Hak} and Lee, {Cheol Whan} and Hong, {Myeong Ki} and Kim, {Jae Joong} and Lee, {Jae Won} and Park, {Seong Wook} and Park, {Seung Jung}",
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Song, JK, Kim, MJ, Yun, SC, Choo, SJ, Song, JM, Song, H, Kang, DH, Chung, CH, Park, DW, Lee, SW, Kim, YH, Lee, CW, Hong, MK, Kim, JJ, Lee, JW, Park, SW & Park, SJ 2010, 'Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery', Journal of Thoracic and Cardiovascular Surgery, vol. 139, no. 1, pp. 103-110. https://doi.org/10.1016/j.jtcvs.2009.04.022

Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery. / Song, Jae Kwan; Kim, Mi Jeong; Yun, Sung Cheol; Choo, Suk Jung; Song, Jong Min; Song, Hyun; Kang, Duk Hyun; Chung, Cheol Hyun; Park, Duk Woo; Lee, Seung Whan; Kim, Young Hak; Lee, Cheol Whan; Hong, Myeong Ki; Kim, Jae Joong; Lee, Jae Won; Park, Seong Wook; Park, Seung Jung.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 139, No. 1, 01.01.2010, p. 103-110.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcomes of percutaneous mitral balloon valvuloplasty versus open cardiac surgery

AU - Song, Jae Kwan

AU - Kim, Mi Jeong

AU - Yun, Sung Cheol

AU - Choo, Suk Jung

AU - Song, Jong Min

AU - Song, Hyun

AU - Kang, Duk Hyun

AU - Chung, Cheol Hyun

AU - Park, Duk Woo

AU - Lee, Seung Whan

AU - Kim, Young Hak

AU - Lee, Cheol Whan

AU - Hong, Myeong Ki

AU - Kim, Jae Joong

AU - Lee, Jae Won

AU - Park, Seong Wook

AU - Park, Seung Jung

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Objectives: We sought to compare long-term outcomes between percutaneous mitral valvuloplasty and open heart surgery. Methods: The study evaluated 402 patients who underwent percutaneous mitral valvuloplasty and 159 patients who underwent open heart surgery between January 1, 1995, and December 31, 2000. The rates of cardiovascular death or repeated intervention (redo percutaneous mitral valvuloplasty or open heart surgery) were determined over a median follow-up of 109 months (mean ± SD, 106 ± 27). The therapeutic effects on adverse outcomes were estimated by the Cox proportional hazards model adjusting differences in the severity of illness before intervention. The effects of the cardiac rhythm and echocardiographic score were also tested. Results: The observed (unadjusted) event-free survival was similar for both groups, and the hazard ratio for the clinical events after percutaneous mitral valvuloplasty as compared with after open heart surgery was 1.510 (95% confidence interval, 0.914-2.496; P = .1079). However, the adjusted hazard ratio was 3.729 (95% confidence interval, 1.963-7.082; P < .0001), showing a higher event-free survival in the open heart surgery group. The adjusted hazard ratio after percutaneous mitral valvuloplasty as compared with after open heart surgery in patients with echocardiographic scores of 8 or more and atrial fibrillation were 5.348 (95% confidence interval, 2.504-11.422; P < .001) and 3.440 (95% confidence interval, 1.805-6.555; P = .0002), respectively, whereas the hazard ratio in patients with echocardiographic scores less than 8 and normal sinus rhythm did not show differences. Conclusions: Open heart surgery was associated with a higher adjusted rate of long-term event-free survival than percutaneous mitral valvuloplasty. Patients with high echocardiographic scores or atrial fibrillation showed better outcomes after open heart surgery.

AB - Objectives: We sought to compare long-term outcomes between percutaneous mitral valvuloplasty and open heart surgery. Methods: The study evaluated 402 patients who underwent percutaneous mitral valvuloplasty and 159 patients who underwent open heart surgery between January 1, 1995, and December 31, 2000. The rates of cardiovascular death or repeated intervention (redo percutaneous mitral valvuloplasty or open heart surgery) were determined over a median follow-up of 109 months (mean ± SD, 106 ± 27). The therapeutic effects on adverse outcomes were estimated by the Cox proportional hazards model adjusting differences in the severity of illness before intervention. The effects of the cardiac rhythm and echocardiographic score were also tested. Results: The observed (unadjusted) event-free survival was similar for both groups, and the hazard ratio for the clinical events after percutaneous mitral valvuloplasty as compared with after open heart surgery was 1.510 (95% confidence interval, 0.914-2.496; P = .1079). However, the adjusted hazard ratio was 3.729 (95% confidence interval, 1.963-7.082; P < .0001), showing a higher event-free survival in the open heart surgery group. The adjusted hazard ratio after percutaneous mitral valvuloplasty as compared with after open heart surgery in patients with echocardiographic scores of 8 or more and atrial fibrillation were 5.348 (95% confidence interval, 2.504-11.422; P < .001) and 3.440 (95% confidence interval, 1.805-6.555; P = .0002), respectively, whereas the hazard ratio in patients with echocardiographic scores less than 8 and normal sinus rhythm did not show differences. Conclusions: Open heart surgery was associated with a higher adjusted rate of long-term event-free survival than percutaneous mitral valvuloplasty. Patients with high echocardiographic scores or atrial fibrillation showed better outcomes after open heart surgery.

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