The efficiency and safety of balloon valvuloplasty in patients with mitral stenosis and a high echo score: mid- and short-term clinical and echocardiographic results [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2009; 37(8): 531-537

The efficiency and safety of balloon valvuloplasty in patients with mitral stenosis and a high echo score: mid- and short-term clinical and echocardiographic results

Mehmet Ekinci, Hamza Duygu, Halit Acet, Faruk Ertaş, Çayan Çakır, Rida Berilgen, Cem Nazlı, Oktay Ergene
Ataturk Training And Research Hospital, Izmir


OBJECTIVES
We aimed to evaluate the success and safety of percutaneous mitral balloon valvuloplasty (PMBV) and its mid-term clinical and echocardiographic results in patients with symptomatic mitral stenosis, including those having a high echo score (9 to 11).

STUDY DESIGN
This prospective study included 57 consecutive patients (9 men, 48 women; mean age 41±9 years) who underwent PMBV with the Inoue technique for symptomatic (NYHA class II-IV) mitral stenosis (valve area <1.5 cm2). The patients were divided into two groups according to the echo scores of ≤8 (group 1, n=25) and >8 (group 2, n=32). Clinical and echocardiographic evaluations were performed before and after 24-48 hours of PMBV and during the follow-up period, including restenosis and major cardiovascular events.

RESULTS
Patients in group 2 had significantly higher rates of atrial fibrillation (53.1% vs. 16%; p=0.006) and functional capacity of NYHA class III-IV (%90.7 vs. %56; p=0.01). Procedural success rates were 96% (n=24) and 90.6% (n=29) in group 1 and 2, respectively. Failure occurred in one patient (4%) in group 1, and in three patients (9.4%) in group 2. One patient in group 1 developed severe mitral stenosis resulting in valve replacement. In group 2, two patients developed hemopericardium. After the procedure, there was a two-fold increase from 1.0±0.1 cm2 to 2.0±0.2 cm2 in the mean valve area, being more prominent in group 1 (group 1: from 1.1±0.1 cm2 to 2.1±0.1 cm2; group 2: from 0.9±0.1 cm2 to 1.8±0.1 cm2; p<0.001). In-hospital mortality or embolic events did not occur, nor did restenosis or major cardiovascular events during a mean follow-up of 21±13 months.

CONCLUSION
Our results show that PMBV can be performed successfully in patients having a low (≤8) or higher (9-11) echo score, with satisfactory hemodynamic and symptomatic improvements.

Keywords: Balloon dilatation, echocardiography, hemodynamics, mitral valve stenosis/therapy

How to cite this article
Mehmet Ekinci, Hamza Duygu, Halit Acet, Faruk Ertaş, Çayan Çakır, Rida Berilgen, Cem Nazlı, Oktay Ergene. The efficiency and safety of balloon valvuloplasty in patients with mitral stenosis and a high echo score: mid- and short-term clinical and echocardiographic results. Turk Kardiyol Dern Ars. 2009; 37(8): 531-537

Corresponding Author: Hamza Duygu, Türkiye
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