TY - JOUR
T1 - Predictors of long-term outcomes of percutaneous mitral valvuloplasty in patients with rheumatic mitral stenosis
AU - Kim, Darae
AU - Chung, Hyemoon
AU - Nam, Jong Ho
AU - Park, Dong Hyuk
AU - Shim, Chi Young
AU - Kim, Jung Sun
AU - Chang, Hyuk Jae
AU - Hong, Geu Ru
AU - Ha, Jong Won
N1 - Publisher Copyright:
© Yonsei University College of Medicine 2018.
PY - 2018/3
Y1 - 2018/3
N2 - 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 cm2 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 cm2 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 cm2 were independent predictors of poor long-term clinical outcomes after PMV, including MV reintervention, stroke, and cardiovascular-related death.
AB - 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 cm2 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 cm2 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 cm2 were independent predictors of poor long-term clinical outcomes after PMV, including MV reintervention, stroke, and cardiovascular-related death.
UR - http://www.scopus.com/inward/record.url?scp=85042084757&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042084757&partnerID=8YFLogxK
U2 - 10.3349/ymj.2018.59.2.273
DO - 10.3349/ymj.2018.59.2.273
M3 - Article
C2 - 29436196
AN - SCOPUS:85042084757
SN - 0513-5796
VL - 59
SP - 273
EP - 278
JO - Yonsei Medical Journal
JF - Yonsei Medical Journal
IS - 2
ER -