Immediate and long-Term Results of Percutaneous Mitral Valvuloplasty Using the Inoue Balloon

Abstract

Background and Objectives:The objective of this study was to assess the shortand long-term clinical outcomes and valvular changes after percutaneous mitral valvuloplasty (PMV) in Sejong Hospital. Subjects and Methods: Four hundred sixty-seven patients received PMV using the Inoue Balloon at Sejong hospital from 1990 to 2002. Short and long-term results, restenosis-free survival rate and prognostic factors for each result were analyzed by Chi-square, Cox regression analysis, Life table method and Cox proportional hazard model. Results:After PMV, mitral valve area increased from 0.94±0.21 cm to 1.76±0.37 cm and the success rate (MVA>1.5 cm or increased by at least 50% without the development of moderate to severe mitral regurgitation) was 78.9%. Age (≤50 years, p=0.018), echo score (≤9, p=0.05) and pre-procedural mitral valve area (MVA, ≥1.1 cm, p=0.001) were independent favorable prognostic factors for short-term result. As for the development of moderate to severe mitral regurgitation, pre-procedural MVA (≤1.0 cm, p=0.031) and echo score (>9, p=0.043) were independent predictive factors. Median restenosis-free survival was 82.98 months and the restenosis-free survival rate was 70.9% at 3 years post-PMV, 48.1% at 6 years and 29.6% at 10 years. The independent prognostic factor for restenosis-free survival rate was left atrial dimension (LAD≤60 mm, p=0.015). In addition, echo score (≤8, p=0.412), pre-procedural MVA (≥1.0 cm, p=0.24) and ejection fraction (EF≥55%, p=0.146) had an effect on the good long-term results of PMV from multivariate analysis. Conclusion:PMV was a very successful treatment method for mitral stenosis. Pre-procedural MVA was a representative predictive factor for short and long-term outcomes and the development of mitral regurgitation. (Korean Circulation J 2003;33 (11):987-995)