Acute and long-term follow-up results of percutaneous mitral balloon valvuloplasty: a single-center study

Korkmaz, Şule; Demirkan, Burcu; Güray, Yeşım; Yılmaz, Mehmet; Aksu, Tolga; Şaşmaz, Hatice

doi:10.5152/akd.2011.136

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…40,41 These parameters also reflect the severity and chronicity of disease and are consistent with previous findings. 13,39,42 The main distinction between our study and previous studies is that we categorized subvalvular involvement in a binary fashion, because the quantification of the severity of the calcification and thickening of the chordae tendinea is difficult, and only severe and extensive subvalvular deformation was a predictor of poor outcome.…”

Section: Predictors Of Mrsupporting

confidence: 78%

The Echo Score Revisited

et al. 2014

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Background-Current echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations.This study examined new, more quantitative methods for assessing valvular involvement and the combination of parameters that best predicts immediate and long-term outcome after PMV. Methods and Results-Two cohorts (derivation n=204 and validation n=121) of patients with symptomatic mitral stenosis undergoing PMV were studied. Mitral valve morphology was assessed by using both the conventional Wilkins qualitative parameters and novel quantitative parameters, including the ratio between the commissural areas and the maximal excursion of the leaflets from the annulus in diastole. Independent predictors of outcome were assigned a points value proportional to their regression coefficients: mitral valve area ≤1 cm 2 (2), maximum leaflets displacement ≤12 mm (3), commissural area ratio ≥1.25 (3), and subvalvular involvement (3). Three risk groups were defined: low (score of 0-3), intermediate (score of 5), and high (score of 6-11) with observed suboptimal PMV results of 16.9%, 56.3%, and 73.8%, respectively. The use of the same scoring system in the validation cohort yielded suboptimal PMV results of 11.8%, 72.7%, and 87.5% in the low-, intermediate-, and high-risk groups, respectively. The model improved risk classification in comparison with the Wilkins score (net reclassification improvement 45.2%; P<0.0001). Long-term outcome was predicted by age and postprocedural variables, including mitral regurgitation, mean gradient, and pulmonary pressure. Conclusions-A scoring system incorporating new quantitative echocardiographic parameters more accurately predicts outcome following PMV than existing models. Long-term post-PMV event-free survival was predicted by age, degree of mitral regurgitation, and postprocedural hemodynamic data. (Circulation. 2014;129:886-895.)

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Section: Predictors Of Mrsupporting

confidence: 78%

The Echo Score Revisited

et al. 2014

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“…Procedural success rates varied widely among studies, even when similar definitions were applied. In general, these rates ranged from 65% to 80%, with some authors reporting rates >90% in considerable sized cohorts 25 34–36. A list of clinical, haemodynamic and morphological variables associated with immediate success is shown in table 1 and online supplementary tables S1 and S2.…”

Section: Immediate Results Of Pmc In the Current Eramentioning

confidence: 99%

Update on percutaneous mitral commissurotomy

Nunes

Nascimento

Lodi-Junqueira

et al. 2016

Heart

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Percutaneous mitral commissurotomy (PMC) is the first-line therapy for managing rheumatic mitral stenosis. Over the past two decades, the indications of the procedure have expanded to include patients with unfavourable valve anatomy as a consequence of epidemiological changes in patient population. The procedure is increasingly being performed in patients with increased age, more deformed valves and associated comorbidities. Echocardiography plays a crucial role in patient selection and to guide a more efficient procedure. The main echocardiographic predictors of immediate results after PMC are mitral valve area, subvalvular thickening and valve calcification, especially at the commissural level. However, procedural success rate is not only dependent on valve anatomy, but a number of other factors including patient characteristics, interventional management strategies and operator expertise. Severe mitral regurgitation continues to be the most common immediate procedural complication with unchanged incidence rates over time. The long-term outcome after PMC is mainly determined by the immediate procedural results. Postprocedural parameters associated with late adverse events include mitral valve area, mitral regurgitation severity, mean gradient and pulmonary artery pressure. Mitral restenosis is an important predictor of event-free survival rates after successful PMC, and repeat procedure can be considered in cases with commissural refusion. PMC can be performed in special situations, which include high-risk patients, during pregnancy and in the presence of left atrial thrombus, especially in centres with specialised expertise. Therefore, procedural decision-making should take into account the several determinant factors of PMC outcomes. This paper provides an overview and update of PMC techniques, complications, immediate and long-term results over time, and assessment of suitability for the procedure.

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“…Korkmaz ve ark.nın yapmış olduğu bir çalışmada akut işlem başarısını öngördüren en önemli parametrenin işlem öncesi MVA olduğu belirtilmiştir. [5] PMBV ile ilişkili mortalite birçok çalışmada %0 ile %3 arasındadır. Ölüm nedenleri kalp tamponadı, ciddi MY gelişimi ve hastaların genel sağlık durumunun kötüleşmesidir.…”

Section: Discussionunclassified

A case of percutaneous mitral balloon valvuloplasty complicated by pericardial effusion and thrombus formation on the interatrial septum

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Küçükseymen

Çağırcı

et al. 2014

Arch Turk Soc Cardiol

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Percutaneous mitral balloon valvuloplasty (PMBV) is the primary treatment in mitral stenosis patients with appropriate valve anatomy with no contraindications present. Pericardial effusion, cardiac tamponade and thrombus formation are rare but serious complications of this procedure. In the literature, the mortality rate associated with PMBV has been reported as 1%. The presence of intracardiac thrombus is a contraindication for PMBV. However, thrombus formation during the process is a very rare condition. In this case, we present a patient with rheumatic mitral stenosis, with both pericardial effusion and intracardiac thrombus, after laseration at the base of the left atrium during the valvuloplasty procedure.

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Acute and long-term follow-up results of percutaneous mitral balloon valvuloplasty: a single-center study

Cited by 9 publications

References 26 publications

The Echo Score Revisited

The Echo Score Revisited

Update on percutaneous mitral commissurotomy

A case of percutaneous mitral balloon valvuloplasty complicated by pericardial effusion and thrombus formation on the interatrial septum

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