Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty

Immediate post-procedural mitral valve area as an important prognosticator

Jae Kwan Song, Jong Min Song, Duk Hyun Kang, Sung Cheol Yun, Duk Woo Park, Seung Whan Lee, Young Hak Kim, Cheol Whan Lee, Myeongki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

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Abstract

Aims: We sought to investigate the factors associated with restenosis and its potential association with late clinical deterioration after successful percutaneous mitral valvuloplasty (PMV).Methods and resultsWe analysed echocardiographic (median 74 months) and clinical (median 109 months) follow-up data of 329 patients who achieved procedural success, defined as mitral valve area (MVA) ≥1.5 cm2 and mitral regurgitation (MR) ≤2/4, between 1995 and 2000. Clinical events included cardiovascular death, mitral valve surgery, and repeat PMV. The 1, 3, 5, 7, and 9 year rates of restenosis-free survival were 99 ± 1, 97 ± 1, 95 ± 1, 86 ± 3, and 72 ± 4, respectively. The 1, 3, 5, 7, and 9 year rates of event-free survival were 99.7 ± 0.3, 96.4 ± 1.0, 94.5 ± 1.3, 90.8 ± 1.6, and 90.0 ± 1.7, respectively. Immediate post-PMV MVA and commissural MR or splitting, indicators of procedural adequacy, were independent predictors of both restenosis and clinical events. The best immediate post-PMV MVA cut-off value for predicting both restenosis and clinical events within 5 years after successful PMV were 1.8 cm2 [95 confidence interval (CI) = 1.7-1.9] and 1.9 cm2 (95 CI = 1.7-2.0), respectively. Patients with immediate post-PMV MVA <1.8 cm2 showed significantly lower event-free survival rate than those with post-PMV MVA ≥1.8 cm2 (P < 0.001).ConclusionImmediate post-PMV MVA≥1.8 cm2 was an important predictor of both restenosis- and clinical event-free survival and this value should be considered as a component of optimal result.

Original languageEnglish
Pages (from-to)1254-1262
Number of pages9
JournalEuropean heart journal
Volume30
Issue number10
DOIs
Publication statusPublished - 2009 May 1

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Mitral Valve
Disease-Free Survival
Mitral Valve Insufficiency
Confidence Intervals
Reoperation
Survival Rate
Survival

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Song, Jae Kwan ; Song, Jong Min ; Kang, Duk Hyun ; Yun, Sung Cheol ; Park, Duk Woo ; Lee, Seung Whan ; Kim, Young Hak ; Lee, Cheol Whan ; Hong, Myeongki ; Kim, Jae Joong ; Park, Seong Wook ; Park, Seung Jung. / Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty : Immediate post-procedural mitral valve area as an important prognosticator. In: European heart journal. 2009 ; Vol. 30, No. 10. pp. 1254-1262.
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title = "Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty: Immediate post-procedural mitral valve area as an important prognosticator",
abstract = "Aims: We sought to investigate the factors associated with restenosis and its potential association with late clinical deterioration after successful percutaneous mitral valvuloplasty (PMV).Methods and resultsWe analysed echocardiographic (median 74 months) and clinical (median 109 months) follow-up data of 329 patients who achieved procedural success, defined as mitral valve area (MVA) ≥1.5 cm2 and mitral regurgitation (MR) ≤2/4, between 1995 and 2000. Clinical events included cardiovascular death, mitral valve surgery, and repeat PMV. The 1, 3, 5, 7, and 9 year rates of restenosis-free survival were 99 ± 1, 97 ± 1, 95 ± 1, 86 ± 3, and 72 ± 4, respectively. The 1, 3, 5, 7, and 9 year rates of event-free survival were 99.7 ± 0.3, 96.4 ± 1.0, 94.5 ± 1.3, 90.8 ± 1.6, and 90.0 ± 1.7, respectively. Immediate post-PMV MVA and commissural MR or splitting, indicators of procedural adequacy, were independent predictors of both restenosis and clinical events. The best immediate post-PMV MVA cut-off value for predicting both restenosis and clinical events within 5 years after successful PMV were 1.8 cm2 [95 confidence interval (CI) = 1.7-1.9] and 1.9 cm2 (95 CI = 1.7-2.0), respectively. Patients with immediate post-PMV MVA <1.8 cm2 showed significantly lower event-free survival rate than those with post-PMV MVA ≥1.8 cm2 (P < 0.001).ConclusionImmediate post-PMV MVA≥1.8 cm2 was an important predictor of both restenosis- and clinical event-free survival and this value should be considered as a component of optimal result.",
author = "Song, {Jae Kwan} and Song, {Jong Min} and Kang, {Duk Hyun} and Yun, {Sung Cheol} and Park, {Duk Woo} and Lee, {Seung Whan} and Kim, {Young Hak} and Lee, {Cheol Whan} and Myeongki Hong and Kim, {Jae Joong} and Park, {Seong Wook} and Park, {Seung Jung}",
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Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty : Immediate post-procedural mitral valve area as an important prognosticator. / Song, Jae Kwan; Song, Jong Min; Kang, Duk Hyun; Yun, Sung Cheol; Park, Duk Woo; Lee, Seung Whan; Kim, Young Hak; Lee, Cheol Whan; Hong, Myeongki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung.

In: European heart journal, Vol. 30, No. 10, 01.05.2009, p. 1254-1262.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty

T2 - Immediate post-procedural mitral valve area as an important prognosticator

AU - Song, Jae Kwan

AU - Song, Jong Min

AU - Kang, Duk Hyun

AU - Yun, Sung Cheol

AU - Park, Duk Woo

AU - Lee, Seung Whan

AU - Kim, Young Hak

AU - Lee, Cheol Whan

AU - Hong, Myeongki

AU - Kim, Jae Joong

AU - Park, Seong Wook

AU - Park, Seung Jung

PY - 2009/5/1

Y1 - 2009/5/1

N2 - Aims: We sought to investigate the factors associated with restenosis and its potential association with late clinical deterioration after successful percutaneous mitral valvuloplasty (PMV).Methods and resultsWe analysed echocardiographic (median 74 months) and clinical (median 109 months) follow-up data of 329 patients who achieved procedural success, defined as mitral valve area (MVA) ≥1.5 cm2 and mitral regurgitation (MR) ≤2/4, between 1995 and 2000. Clinical events included cardiovascular death, mitral valve surgery, and repeat PMV. The 1, 3, 5, 7, and 9 year rates of restenosis-free survival were 99 ± 1, 97 ± 1, 95 ± 1, 86 ± 3, and 72 ± 4, respectively. The 1, 3, 5, 7, and 9 year rates of event-free survival were 99.7 ± 0.3, 96.4 ± 1.0, 94.5 ± 1.3, 90.8 ± 1.6, and 90.0 ± 1.7, respectively. Immediate post-PMV MVA and commissural MR or splitting, indicators of procedural adequacy, were independent predictors of both restenosis and clinical events. The best immediate post-PMV MVA cut-off value for predicting both restenosis and clinical events within 5 years after successful PMV were 1.8 cm2 [95 confidence interval (CI) = 1.7-1.9] and 1.9 cm2 (95 CI = 1.7-2.0), respectively. Patients with immediate post-PMV MVA <1.8 cm2 showed significantly lower event-free survival rate than those with post-PMV MVA ≥1.8 cm2 (P < 0.001).ConclusionImmediate post-PMV MVA≥1.8 cm2 was an important predictor of both restenosis- and clinical event-free survival and this value should be considered as a component of optimal result.

AB - Aims: We sought to investigate the factors associated with restenosis and its potential association with late clinical deterioration after successful percutaneous mitral valvuloplasty (PMV).Methods and resultsWe analysed echocardiographic (median 74 months) and clinical (median 109 months) follow-up data of 329 patients who achieved procedural success, defined as mitral valve area (MVA) ≥1.5 cm2 and mitral regurgitation (MR) ≤2/4, between 1995 and 2000. Clinical events included cardiovascular death, mitral valve surgery, and repeat PMV. The 1, 3, 5, 7, and 9 year rates of restenosis-free survival were 99 ± 1, 97 ± 1, 95 ± 1, 86 ± 3, and 72 ± 4, respectively. The 1, 3, 5, 7, and 9 year rates of event-free survival were 99.7 ± 0.3, 96.4 ± 1.0, 94.5 ± 1.3, 90.8 ± 1.6, and 90.0 ± 1.7, respectively. Immediate post-PMV MVA and commissural MR or splitting, indicators of procedural adequacy, were independent predictors of both restenosis and clinical events. The best immediate post-PMV MVA cut-off value for predicting both restenosis and clinical events within 5 years after successful PMV were 1.8 cm2 [95 confidence interval (CI) = 1.7-1.9] and 1.9 cm2 (95 CI = 1.7-2.0), respectively. Patients with immediate post-PMV MVA <1.8 cm2 showed significantly lower event-free survival rate than those with post-PMV MVA ≥1.8 cm2 (P < 0.001).ConclusionImmediate post-PMV MVA≥1.8 cm2 was an important predictor of both restenosis- and clinical event-free survival and this value should be considered as a component of optimal result.

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DO - 10.1093/eurheartj/ehp096

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JO - European Heart Journal

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