Long-Term Results up to 19 Years of Mitral Balloon Valvuloplasty

Abstract

Clinical and echocardiographic data of 547 consecutive patients (mean age, 31.5 years) undergoing mitral balloon valvuloplasty with follow-up of 1.5–19 years, were analyzed. Immediately after valvuloplasty, mitral valve area increased significantly from 0.92 ± 0.17 to 1.95 ± 0.29 cm². Restenosis occurred in 169 (31%) patients; it was less common (20%) in those with a mitral echocardiographic score ≤8. Actuarial freedom from restenosis at 10, 15, and 19 years was 78% ± 2%, 52% ± 3%, and 26 ± 4%, respectively, and significantly higher in patients with echocardiographic scores ≤8: 88% ± 2%, 67% ± 4%, and 40% ± 6%, respectively. Event-free survival at 10, 15, and 19 years was 88% ± 2%, 60% ± 4%, and 28% ± 7%, respectively, and significantly higher in patients with echocardiographic scores ≤8: 92% ± 1%, 70% ± 4%, and 42% ± 7%, respectively. Multivariate analysis identified echocardiographic score ≤8 and post-procedure valve area ≤1.8 as predictors of restenosis, and echocardiographic score > 8 and preexisting atrial fibrillation as predictors of combined events. Valvuloplasty provides excellent results in selected patients with mitral stenosis. The long-term outcome can be predicted from the baseline characteristics of the mitral valve.