Turk Kardiyol Dern Ars. 2011; 39(2): 137-142 | DOI: 10.5543/tkda.2011.01375
Acute results of percutaneous mitral balloon valvuloplasty
, Tolga Aksu2
, Hatice Sasmaz2
, Ayse Colak2
, Mehmet Birhan Yılmaz3
, Yesim Guray2
, Umit Guray2
, Burcu Demirkan21
Ufuk University Doctor Rıdvan Ege Education And Research Hospital, Department of Cardiology, Ankara, Turkey2
Ankara Yuksek Ihtisas Education And Research Hospital, Department of Cardiology, Ankara, Turkey3
Cumhuriyet University School of Medicine, Department of Cardiology, Sivas, Turkey
OBJECTIVES We aimed to analyze acute clinical, echocardiographic, and hemodynamic results and long-term event-free survival of percutaneous mitral balloon valvuloplasty (PMBV) in the treatment of hemodynamically significant mitral stenosis (MS).
STUDY DESIGN We retrospectively reviewed 577 patients (454 females, 123 males; mean age 38±11 years) who underwent PMBV for moderate or severe MS. Acute procedural success was defined as the achievement of mitral valve area (MVA) >1.5 cm2 and absence of grade 3-4 mitral regurgitation. In addition, 489 patients were interrogated by phone calls for event-free survival (death, redo PMBV, mitral valve replacement) after at least one year (mean 54 months) of the procedure.
RESULTS The procedure was successful in 547 patients (94.8%) and unsuccessful in 30 patients (5.2%). Among baseline echocardiographic and hemodynamic parameters, MVA was significantly lower (p=0.0001) and moderate/severe tricuspid regurgitation was significantly more common (p=0.031) in patients with failure. The mean Wilkins scores were similar in the two groups (p>0.05). Failure was related to suboptimal valve opening (MVA <1.5 cm2) in 20 patients (66.7%), and grade 3-4 mitral regurgitation in 10 patients (33.3%). There were no in-hospital death, cardiac tamponade, or cerebrovascular accident. Acute complications included iatrogenic atrial septal defect (n=51, 8.8%) and groin hematoma (n=4, 0.7%). Inquiry for long-term outcomes showed that four patients had died, while 21 patients and six patients had undergone mitral valve replacement and redo PMBV, respectively.
CONCLUSION Our data suggest that PMBV is a safe and effective treatment option in MS and preprocedural MVA and tricuspid regurgitation are associated with acute failure of the procedure.
Balloon dilation/methods, echocardiography, mitral valve insufficiency/therapy, mitral valve stenosis/therapy
How to cite this article
Şule Korkmaz, Tolga Aksu, Hatice Sasmaz, Ayse Colak, Mehmet Birhan Yılmaz, Yesim Guray, Umit Guray, Burcu Demirkan. Acute results of percutaneous mitral balloon valvuloplasty. Turk Kardiyol Dern Ars. 2011; 39(2): 137-142
Corresponding Author: Tolga Aksu, Türkiye