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Mitral valve balloon dilatation: long-term results
1Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Journal of Cardiac Surgery
|March 1, 1994
Summary
Mitral valve balloon dilatation shows good long-term results for selected patients with mitral stenosis. Baseline patient characteristics can predict outcomes, aiding in patient selection for this investigational procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Mitral valve balloon dilatation (MVBD) has an 85% initial success rate but is investigational due to technical challenges and uncertain long-term outcomes.
- Limited adoption of MVBD stems from its complexity and unpredictable long-term results.
Purpose of the Study:
- To identify predictors of long-term results following mitral valve balloon dilatation.
- Establish factors influencing survival and restenosis after MVBD.
Main Methods:
- Analysis of 738 patients from 24 centers at 30-day follow-up.
- Long-term follow-up (up to 5 years) of patient cohorts (n=17, n=146, n=350).
- Assessment of quality of life using the Sickness Impact Profile.
Main Results:
- At 30 days, 83% of patients improved, 4% needed surgery, and 3% died.
- Five-year overall survival was 76% (n=146) and 94% (younger cohort, n=350).
- Predictors of survival included age and NYHA class; restenosis predictors were valve calcification and leaflet thickening.
Conclusions:
- Mitral valve balloon dilatation offers favorable long-term outcomes in carefully selected mitral stenosis patients.
- Predicting long-term results is feasible using baseline clinical and echocardiographic features.