Long term results of percutaneous mitral balloon valvuloplasty; 19-year Turkish experience

Abstract

Background: Percutaneous Balloon Mitral Valvuloplasty (PBMV) should be considered first-line therapy in most patients with mitral stenosis. Purpose: To evaluate acute clinical, hemodynamic, echocardiographic and long-term outcome of our PBMV experience. Method: 404 patients with rheumatic mitral stenosis were studied between 1994-2010. PBMV was performed with Inoue balloon. Ideal balloon size was measured according to patients' height. All patients underwent standart Transesophageal (TEE) and Transthoracic (TTE) echocardiographic examination before and after PBMV. Follow-up was scheduled every 6 months in the first year and yearly thereafter. Results: PBMV was successful in all patients (mean age 37.65±9.9 years). Wilkins score was 7.65±1.78.Mean procedure time was 27.9±12. min. Baseline characteristics is shown in table 1. Post-PBMV Mitral Valve Area (MVA) was significantly higher with low mean transmitral gradient (MVA 1.15±0.73 vs 1.95±0.31 p<0.001, mean transmitral gradient 14.57±5.98 vs 5.81±2.76 p<0.01). Pulmonary capillary wedge pressure (PCWP) significantly decreased after PBMV (25.26±7.69 vs 11.84±6.1, p<0.01).Follow-up duration was 91,4±27,2 months. 25 Patients underwent to mitral valve replacement due to restenosis or progression of mitral regurgitation. 11 patients underwent to re-PBMV due to restenosis. At the last follow-up MVA was 1.53±0.36 cm2 and mean transmitral gradient was 8.02±3.87 mmHg. View this table: Baseline characteristics Conclusion: PBMV is an effective therapy with low procedure time in well-experienced centre and has comparable long-term results with surgery.