The Prediction of Successful Outcome after Percutaneous Mitral Valvuloplasty

Abstract

Background:Several predictors of successful outcome after percutaneous mitral valvuloplsty (PMV) have been identified but the results were controversial. We analyzes the clinical and echocardiographic predictors of successful outcome after PMV. Methods:We studied 214 patients(167 women and 47 men) undergoing PMV from October 1991 to December 1995. Echocardiographic evaluation was performed before and after PMV. Results:The study population had mean age of 41±11 years, and the total echocardiographic score was 7.5±1.5. PMV using Inoue balloon and double balloon technique were performed in 113 cases and 101 cases respectively. The successful outcome from PMV(defined as mitral valve area ≥ 1.5cm and increase in valve area ≥25% and less than grade 3 mitral regurgitation(MR)) was achieved in 178 cases(83.2%). The mean mitral valve area was increased from 0.90±0.21cm 2 to 1.82±0.34cm(p 8(0.83±0.22cm, p<0.01). Significant MR(≥grade 3 MR) after PMV was developed in 10 cases(4.7%). In patients with significant MR after PMV, echocardiographic calcification score were high(2.3±0.8 vs. 1.7±0.7, p<0.01) and mitral valve area before PMV were smaller(0.82±0.10cm vs. 0.90±0.22cm , p<0.05) than in those without significant MR. Conclusions:The predictors of successful outcome after PMV are large mitral valve area and good echocardiograpic score. The predictors of significant MR is severe calcified mitral valve and small mitral valve area before PMV.