Related Experiment Video
Updated: Nov 10, 2025
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Clinical and echocardiographic trends in percutaneous balloon mitral valvuloplasty
Ofir Koren1,2, Asaf Israeli3, Ehud Rozner4
1Heart Institute, Emek Medical Center, 21 Yitzhak Rabin Boulevard, 18101, Afula, Israel. Ofirko1@clalit.org.il.
Background:
The prevalence of Rheumatic Mitral Stenosis (MS) has significantly changed over the last decades. We intend to examine patient demographics, Echocardiographic characteristics, procedural success rates, and complications throughout 30-years.
Methods:
We conducted a single-center descriptive observational study. The study population consists of patients undergone percutaneous balloon mitral valvuloplasty (PBMV) at Emek Medical Center in Israel from January 1990 to May 2019.
Results:
Four hundred seventeen patients underwent PBMV during the study period and were eligible for the study. Age did not change significantly over time (p = 0.09). The prevalence of Male and patients who were smoking and had multiple comorbidities such as hypertension, dyslipidemia, ischemic heart disease, and chronic kidney disease became increases over time (p = 0.02, p = 0.02, p = 0.001, p = 0.01, p = 0.02, and p = 0.001, respectively). Wilkins score and all its components increased over time, and the total score was higher in females (p = 0.01). Seventy-nine (18.9%) patients had complications. The rate of complications did not change over decades. Patients with Wilkins score > 8, post-procedural MR of ≥2, and post-procedural MVA < 1.5 had the highest risk for the need of Mitral valve replacement (MVR) surgery in 2 years following PBMV (3.64, 4.03, 2.44, respectively, CI 95%, p < .0001 for all). The median time in these patients was 630 days compared to 4-5 years in the entire population. Patients with Post-procedural MR of ≥2 and post-procedural MVA < 1.5 had ten times risk for developing heart failure (HR 9.07 and 10.06, respectively, CI 95%, P < .0001).
Conclusion:
Our research reveals trends over time in patients' characteristics and echocardiographic features. Our study population consists of more male patients with multiple comorbidities and more complex and calcified valvular structures in the last decade. Wilkins score > 8, post-procedural MR of ≥2, and post-procedural MVA < 1.5 cm2 were in-depended predictors for the time for surgery and heart failure hospitalization.
Insights
Over 30 years, percutaneous balloon mitral valvuloplasty patients showed increasing comorbidities and complex valve structures. Higher Wilkins scores and post-procedural mitral regurgitation/stenosis predict future surgery and heart failure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Rheumatic Mitral Stenosis (MS) prevalence has evolved over recent decades.
- Understanding long-term trends in patient demographics and procedural outcomes is crucial.
Purpose of the Study:
- To analyze changes in patient characteristics and echocardiographic features of Rheumatic Mitral Stenosis over 30 years.
- To evaluate procedural success rates and complication patterns of percutaneous balloon mitral valvuloplasty (PBMV).
Main Methods:
- A single-center descriptive observational study was conducted.
- Data from 417 patients undergoing PBMV between January 1990 and May 2019 were analyzed.
Main Results:
- Patient demographics shifted towards more males with increased smoking, hypertension, dyslipidemia, ischemic heart disease, and chronic kidney disease.
- Wilkins scores, indicating valve calcification and complexity, increased over time, particularly in females.
- Complication rates remained stable, but higher Wilkins scores, post-procedural mitral regurgitation (MR) ≥2, and mitral valve area (MVA) <1.5 cm² predicted increased need for mitral valve replacement (MVR) surgery and heart failure hospitalization.
Conclusions:
- Patient populations undergoing PBMV for Rheumatic Mitral Stenosis have become more complex over 30 years.
- Increased comorbidities and calcified valve structures necessitate careful procedural planning.
- Predictors for adverse outcomes include elevated Wilkins scores, post-procedural MR, and reduced MVA, guiding future management strategies.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:22Mitral Valve Prolapse II: Assessment and Management
01:27Mitral Valve Prolapse I: Introduction
01:25Mitral Regurgitation III: Medical Management
01:19Mitral Valve Prolapse III: Nursing Management