Mitral valve balloon dilatation: long-term results

Although initial success rates for mitral valve balloon dilatation are currently about 85%, the procedure remains investigational and is not performed in many centers because the procedure is technically challenging and has uncertain long-term results.

The purpose of this report is to identify the predictors of long-term results after mitral valve balloon dilatation.

At 30-day follow-up of 738 patients treated at 24 centers (mean age 54 years), 4% of patients required mitral valve surgery, 3% had died, and 83% had their overall condition improved. At 2-month and 1-year follow-up of 17 patients treated at one center, quality of life showed sustained improvement as measured by the Sickness Impact Profile. At 5-year follow-up of 146 patients treated at a single center (mean age 59 years), overall survival was 76% and event-free survival was 51%. At 5-year follow-up of a younger group of 350 patients (mean age 46 years), overall survival was 94% and event-free survival was 85%. Predictors of survival after mitral balloon dilatation included age and baseline New York Heart Association functional class. Predictors of restenosis included the presence of valve calcification and leaflet thickening.

Mitral valve balloon dilatation has good long-term outcome for selected patients with mitral stenosis. The long-term outcome after this procedure can be predicted from baseline clinical and valvular characteristics.