910-22 Mitral Regurgitation (not Restenosis) is the Most Frequent Indication for Valve Replacement After Balloon Mitral Valvotomy

Abstract

The indications for mitral valve replacement (MVR) after balloon mitral valvotomy (BMV) remain poorly characterized. Restenosis has been the focus of most concerns regarding the long-term need for re-BMV or MVR. We reviewed the indications for MVR after BMV in 770 patients during 3 years. Indication for MVR: < 30 days (n = 34) > 30 days (n = 47) Restenosis 0 15% CHF 0 30% Failed BMW 15% 9% MR 85% 46% MVR was necessary in 4.5% within 30 days of BMV The indication for MVR was mitral regurgitation (MR) in 3.8% and failed BMV in 0.7%. Late MVR (more than 30 days post BMV) was done in an additional 6.1%. MVR was most frequently necessary for increasing MR or symptoms due to mixed or multiple valve lesions (p < 0.001). Restenosis (loss of half the initial gain in mitral area) accounted for only 15% of the indications for MVR. Restenosis is an infrequent indication for MVR after BMV. Other factors including initially insufficient enlargement of the mitral orifice, persistent symptoms, and progression of post-BMV MR are the major indications for MVR after balloon mitral valvotomy.