Percutaneous mitral balloon valvuloplasty: beyond classic indications

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Percutaneous mitral balloon valvuloplasty (PMBV) is a treatment for mitral stenosis (MS).
• Evidence supports PMBV for asymptomatic MS with MVA 1.0-1.5 cm2.
• No follow-up data exist for symptomatic MS with MVA > 1.5 cm2 undergoing PMBV.

Purpose of the Study:

• To evaluate periprocedural results of PMBV in symptomatic MS patients with MVA > 1.5 cm2.
• To compare these results with a control group of patients with MVA ≤ 1.5 cm2.

Main Methods:

• Retrospective analysis of 113 symptomatic MS patients (MVA > 1.5 cm2) undergoing PMBV.
• Comparison with a control group (MVA ≤ 1.5 cm2).
• Analysis of clinical and procedural variables.

Main Results:

• PMBV increased MVA and decreased mitral gradients, left atrial pressure (LAP), and pulmonary artery pressures (PAPs) in both groups.
• 6.3% of patients developed moderate to severe or severe mitral regurgitation (MR).
• MVA increase and LAP decrease were more pronounced in the MVA ≤ 1.5 cm2 group, but PAP changes were similar.

Conclusions:

• PMBV is feasible in selected symptomatic MS patients with MVA > 1.5 cm2, even without classic echocardiographic indications.
• The procedure is associated with a small but significant risk of periprocedural severe MR.
• Careful patient selection is crucial for successful PMBV outcomes.