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Very Long Term Follow-Up After Percutaneous Balloon Mitral Valvuloplasty
Rafael A Meneguz-Moreno1, J Ribamar Costa2, Nisia L Gomes3
1Department of Interventional Cardiology, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil; Department of Medicine, Universidade Federal de Sergipe, Sergipe, Brazil.
JACC. Cardiovascular Interventions
|August 6, 2018
Summary
Percutaneous balloon mitral valvuloplasty (PBMV) offers sustained results for over 75% of patients with severe mitral stenosis. Key predictors of long-term success include age, symptoms, and post-procedure mitral valve area.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Percutaneous balloon mitral valvuloplasty (PBMV) is a primary treatment for severe symptomatic rheumatic mitral stenosis with suitable anatomy.
- This procedure offers a less invasive alternative to surgery for select patients.
Purpose of the Study:
- To evaluate the very long-term outcomes of successful PBMV.
- To identify predictors of sustained success and potential complications after PBMV.
Main Methods:
- A cohort of 1,582 patients who underwent successful PBMV between 1987 and 2010 were analyzed.
- The primary endpoint was a composite of all-cause mortality, need for mitral surgery, or repeat PBMV, assessed up to 23 years post-procedure.
- Long-term follow-up was achieved in 79.1% of successful cases.
Main Results:
- Acute success was achieved in 90.9% of patients.
- The incidence of the primary endpoint (mortality, surgery, or repeat PBMV) was 19.1% over a median follow-up of 8.3 years.
- Independent predictors of adverse outcomes included advanced NYHA functional class (III/IV), higher age, and a post-procedural mitral valve area ≤1.75 cm².
Conclusions:
- Over 75% of patients demonstrated sustained positive results in very long-term follow-up.
- Predictors of favorable late outcomes are multifactorial, significantly influenced by patient age, baseline symptoms, and the mitral valve area achieved post-PBMV.
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