Factors influencing progression of mitral regurgitation after transarterial balloon valvuloplasty for mitral stenosis

Sancho, Manuel; Medina, Alfonso; Lezo, JoséSuárez de; Hernández, Enrique; Pan, Manuel; Coello, I; Romero, Miguel; Melián, Francisco; Segura, José; Jiménez, Francisco Pérez; Vivancos, Ricardo; Laraudogoitia, Eva; Vallés, F

doi:10.1016/0002-9149(90)91140-2

Cited by 20 publications

(2 citation statements)

References 14 publications

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“…In total, we identified 3,212 records among which 83 studies were finally included (Supplementary Figure 1) [ 8 9 10 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 ...…”

Section: Resultsmentioning

confidence: 99%

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Noubiap

Nyaga²,

Ndoadoumgue

et al. 2020

Global Heart

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Objective: To estimate the incidence, prevalence, and correlates of atrial fibrillation (AF) in a global population with rheumatic heart disease (RHD). Methods: Bibliographic databases were searched to identify all published studies providing data on AF in patients with RHD. Random-effects meta-analysis method was used to pool estimates. Results: Eighty-three studies were included, reporting data from 75,637 participants with RHD in 42 countries. The global prevalence of AF in RHD was 32.8% (range: 4.3%-79.9%). It was higher in severe valvular disease (30.8% vs 20.7%, p = 0.009), in severe mitral valve disease compared to severe aortic disease (30.4% vs 6.3%, p = 0.038). The global cumulative incidence of AF in patients with RHD was 4.8%, 11.4%, 13.2%, and 30.8% at 1, 2, 5, and 10 years of follow-up, respectively. From comparison between patients with and without AF, AF was associated with increased age (mean difference [MD]: 9.5 years; 95% CI: 7.8-1.3), advanced heart failure (odds ratio [OR]: 4.4; 95% CI 2.1-9.3), tricuspid valve involvement (OR: 4.

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Section: Resultsmentioning

confidence: 99%

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Noubiap

Nyaga²,

Ndoadoumgue

et al. 2020

Global Heart

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“…Severe MR, however, which frequently requires intensive medical therapy and surgery, occurs in up to 15% of patients after PMV 12,16,17,21 and continues to be one of the most important complications of this procedure. In a report that showed temporal trends in PMV from 1986 to 2001, Iung et al 7 found the technical failure rate found to have decreased significantly, whereas the frequency of severe MR remained stable over time.…”

Section: Mr After Pmvmentioning

confidence: 99%

Long-Term Outcomes of Significant Mitral Regurgitation After Percutaneous Mitral Valvuloplasty

Kim

Song

et al. 2006

Circulation

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Background-Mild commissural mitral regurgitation (MR) is associated with significantly higher restenosis-free survival after percutaneous mitral valvuloplasty (PMV), which suggests that different mechanisms of significant MR after PMV may have different clinical courses. We therefore analyzed long-term prognostic factors of significant MR after PMV. Methods and Results-Echocardiographic and clinical follow-up data on 380 patients were analyzed (286 women, mean age 44Ϯ11 years) who underwent PMV with the Inoue balloon technique between 1995 and 2000. Significant MR developed in 47 patients (12.4%). The survival rate at 8 years was 96Ϯ3% and 98Ϯ10% in patients with and without significant MR, respectively (Pϭ0.084). The most frequent mechanism was commissural MR, or MR that originated at the site of successful commissurotomy, which occurred in 27 of 47 patients (57%), whereas noncommissural MR occurred in 20 (43%) patients, 12 (26%) with subvalvular damage resulting in chordae rupture and flail motion and 8 (17%) with leaflet laceration. The 8-year event-free survival rate was significantly lower in patients with significant MR than in those without (47Ϯ8% versus 83Ϯ3%, PϽ0.001) and was significantly higher in patients with commissural versus noncommissural MR (63Ϯ11% versus 29Ϯ11%, PϽ0.001). Of the 47 patients with significant MR, who were followed up for 74Ϯ29 months, 19 patients (40%) underwent mitral valve replacement, and 28 patients (60%) received medical treatment only. Patients with commissural MR had a significantly lower rate of mitral valve replacement than patients with noncommissural MR (15% versus 70%, PϽ0.001). Multivariate analysis showed that atrial fibrillation (odds ratio, 7.4; 95% CI, 1.1 to 56.4; Pϭ0.038), mean mitral gradient immediately after PMV (odds ratio, 1.5; 95% CI, 1.1 to 2.0; Pϭ0.009), and the mechanism of MR (odds ratio, 16.7; 95% CI, 2.3 to 122.2; Pϭ0.005) were independent factors associated with mitral valve replacement. Conclusions-Clinical outcome of patients with significant MR after PMV varied according to MR mechanism and the adequacy of hemodynamic improvement, which is easily assessed by echocardiography immediately after PMV.

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Balloon valvuloplasty for mild mitral stenosis

Pan¹,

Medina²,

Lezo³

et al. 1991

Cathet. Cardiovasc. Diagn.

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Of a total number of 288 patients with mitral stenosis treated by percutaneous balloon valvuloplasty, 21 patients had a basal mitral area equal to or greater than 1.5 cm2, as measured hemodynamically. The immediate hemodynamic results of this particular group of patients with mild mitral stenosis are described, as well as the clinical and echo doppler findings at follow-up (22 +/- 12 mo). Patients with mild mitral stenosis (group I) had more pliable valves (p less than 0.01), as assessed by echo, and higher incidence of sinus rhythm (p less than 0.02) than that observed in the remaining 267 patients (group II). After valvuloplasty the valve area increased in group I from 1.7 +/- 0.2 to 3.1 +/- 0.7 cm2 (p less than 0.0001). This mean final area was significantly different (p less than 0.0001) than that observed in group II (1.98 +/- 0.6 cm2). No patients with mild mitral stenosis developed progression of mitral regurgitation, and none had any other major complications. Most of them reached a grade I final functional status. At echo doppler follow-up studies we did not observe significant changes in the mean mitral gradient as compared with the immediate hemodynamic results. These findings suggest that early mitral balloon valvuloplasty could be an alternative in trying to favorably influence the natural course of the rheumatic mitral disease in selected patients.

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Factors influencing progression of mitral regurgitation after transarterial balloon valvuloplasty for mitral stenosis

Cited by 20 publications

References 14 publications

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Long-Term Outcomes of Significant Mitral Regurgitation After Percutaneous Mitral Valvuloplasty

Balloon valvuloplasty for mild mitral stenosis

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