Is redo mitral balloon valvuloplasty as efficient and safe as a first procedure?

Abstract

Introduction: Since its introduction in 1984, mitral balloon valvuloplasty became the treatment of choice for mitral stenosis. After a successful procedure, the major event on long follow up is restenosis which treatment is discussed between surgeries or redo Mitral Balloon Valvuloplasty (MBV). Methods: Our study was a retrospective and descriptive study in the hospital between 1998 and 2008, 302 patients underwent a mbv. Among these patients 35 required a new mitral balloon valvuloplasty during follow-up. In this study we report the immediate and long term results of this redo procedure and compare our results with the initial group of 302 patients who got a first MBV. Results: Both groups were similar in terms of age (34±13 for de novo group versus 32±11 for redo group) and female percentage 77% vs 85% (p=0,24). There was no difference between groups in term of pre procedural mitral valve area: (0.98±0.21 for the 302 patients and 1.01±0.20 for the 35 others), valve morphology quantified using the Wilkins score and pulmonary systolic pressures. The procedure was successful for 85% of patients of the de novo group and only 77% for the redo group (p =0.10).There was no exceed in major immediate complications such as hemopericardium, acute severe mitral regurgitation or death. During follow up eight cases or restenosis were noticed among the 35 patients group within a mean period of 20 months versus 41 cases in the other group. But the difference wasn't statistically significant. Conclusion: Repeat MBV results in good immediate and long term outcomes with no exceed of complications especially in patients with favorable anatomic forms.