Predictors of long-term outcomes of percutaneous mitral valvuloplasty in patients with rheumatic mitral stenosis

Darae Kim, Hyemoon Chung, Jong Ho Nam, Dong Hyuk Park, Chi Young Shim, Jung Sun Kim, Hyuk Jae Chang, Geu Ru Hong, Jong Won Ha

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3 Citations (Scopus)

Abstract

Purpose: We determined factors associated with long-term outcomes of patients who underwent successful percutaneous mitral balloon valvuloplasty (PMV). Materials and Methods: Between August 1980 and May 2013, 1187 patients underwent PMV at Severance Hospital, Seoul, Korea. A total of 742 patients who underwent regular clinic visits for more than 10 years were retrospectively analyzed. The endpoints consisted of repeated PMV, mitral valve (MV) surgery, and cardiovascular-related death. Results: The optimal result, defined as a post-PMV mitral valve area (MVA) >1.5 cm 2 and mitral regurgitation ≤Grade II, was obtained in 631 (85%) patients. Over a mean follow up duration of 214±50 months, 54 (7.3%) patients underwent repeat PMV, 4 (0.5%) underwent trido-PMV, and 248 (33.4%) underwent MV surgery. A total of 33 patients (4.4%) had stroke, and 35 (4.7%) patients died from cardiovascular-related reasons. In a multivariate analysis, echocardiographic score [p=0.003, hazard ratio=1.56, 95% confidence interval (CI): 1.01−2.41] and post-MVA cut-off (p<0.001, relative risk=0.39, 95% CI: 0.37−0.69) were the only significant predictors of long-term clinical outcomes after adjusting for confounding variables. A post-MVA cut-off value of 1.76 cm 2 showed satisfactory predictive power for poor long-term clinical outcomes. Conclusion: In this long-term follow up study (up to 20 years), an echocardiographic score >8 and post-MVA ≤1.76 cm 2 were independent predictors of poor long-term clinical outcomes after PMV, including MV reintervention, stroke, and cardiovascular-related death.

Original languageEnglish
Pages (from-to)273-278
Number of pages6
JournalYonsei medical journal
Volume59
Issue number2
DOIs
Publication statusPublished - 2018 Mar

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All Science Journal Classification (ASJC) codes

  • Medicine(all)

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