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Long term outcome of percutaneous mitral balloon valvotomy in patients aged 70 and over

N Sutaria1, A T Elder, T R Shaw

  • 1Department of Cardiology, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.

Heart (British Cardiac Society)
|March 18, 2000
PubMed

Insights

Percutaneous mitral balloon valvotomy offers significant hemodynamic improvement and symptomatic relief in elderly patients over 70. This safe procedure provides a valuable palliative option for those unsuitable for surgery.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Severe mitral stenosis in elderly patients presents a significant clinical challenge.
  • Surgical intervention for mitral stenosis in patients over 70 is often associated with high risk due to comorbidities.
  • Percutaneous mitral balloon valvotomy (PMBV) has emerged as a less invasive alternative.

Purpose of the Study:

  • To evaluate the immediate hemodynamic effects of PMBV.
  • To assess the long-term symptomatic benefits of PMBV in patients aged 70 years and older.
  • To determine the safety and efficacy of PMBV as a palliative treatment in this population.

Main Methods:

  • A prospective study was conducted at a tertiary referral center.
  • Eighty patients aged 70 and above underwent PMBV.
  • Hemodynamic parameters were measured pre- and post-procedure, with follow-up ranging from 1 to 10 years.

Main Results:

  • PMBV resulted in an 89% increase in mitral valve area (from 0.84 to 1.59 cm²).
  • Complication rates were low, with only two patients experiencing long-term major sequelae.
  • At 5 years, 25% of surgically unsuitable patients and 36% of suitable patients remained free from valve replacement and showed symptom improvement.

Conclusions:

  • PMBV is a safe and effective palliative procedure for elderly patients with mitral stenosis, particularly those unsuitable for surgery.
  • The procedure offers significant hemodynamic improvement and long-term symptomatic benefit.
  • While echo score is used to predict outcomes, it is an imperfect predictor of hemodynamic improvement.
Abstract

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