Follow-up of patients undergoing percutaneous mitral balloon valvotomy. Analysis of factors determining restenosis.

Palacios, Igor F.; Block, Peter C.; Wilkins, Gerard T.; Weyman, Arthur E.

doi:10.1161/01.cir.79.3.573

Cited by 251 publications

(88 citation statements)

References 21 publications

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“…Percutaneous mitral balloon valvuloplasty (PBMV) is an effective therapy in patients with symptomatic mitral stenosis (MS) [1][2][3]. In addition, PBMV is the best choice for isolated MS with favorable morphology [4].…”

Section: Introductionmentioning

confidence: 99%

Should we wait until severe pulmonary hypertension develops? Efficacy of percutaneous mitral balloon valvuloplasty in patients with severe pulmonary hypertension: A subgroup analysis of our experience

Özkan¹,

Bozat²,

Tiryakioğlu³

et al. 2016

Cardiol J.

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Section: Introductionmentioning

confidence: 99%

Should we wait until severe pulmonary hypertension develops? Efficacy of percutaneous mitral balloon valvuloplasty in patients with severe pulmonary hypertension: A subgroup analysis of our experience

Özkan¹,

Bozat²,

Tiryakioğlu³

et al. 2016

Cardiol J.

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“…Other studies, using the same definition, reported success rates ranging from 70 to 90%. 3,17 In all patients, PMV was performed with the Inoue balloon technique. The main advantages of this technique (versus the double-balloon technique) are the absence of a guidewire in the left ventricle, the self-positioning of the balloon, and the ability to perform stepwise inflations under echo guidance to monitor commissural opening.…”

Section: Discussionmentioning

confidence: 99%

Mean pulmonary arterial pressure after percutaneous mitral valvuloplasty predicts long-term adverse outcomes

Jorge

Baptista

Faria

et al. 2012

Revista Portuguesa de Cardiologia (English Edition)

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Introduction and aim: Percutaneous mitral valvuloplasty (PMV) is an effective treatment option for mitral stenosis (MS), but its success is assessed on the basis of clinical and echocardiographic outcomes in studies with relatively short follow-up. We aimed to characterize a cohort of patients undergoing PMV with long-term follow-up and to determine independent predictors of post-PMV mitral re-intervention and event-free survival. Methods: We studied 91 consecutive patients with MS who underwent PMV with a median clinical follow-up duration of 99 months. Two endpoints were considered: post-PMV mitral re-intervention (PMV or mitral surgery) and a composite clinical events endpoint including cardiovascular death, mitral valve re-intervention and hospital admission due to decompensated heart failure. We compared patients who required post-PMV mitral re-intervention with those who did not during follow-up. Results: The study population included 83.5% females and mean age was 48.9 ± 13.9 years. The 1-, 3-, 5-, 7-and 9-year rates of clinical event-free survival were 93.0 ± 2.8%, 86.0 ± 3.9%, 81.0 ± 4.4%, 70.6 ± 5.6%, and 68.4 ± 5.8%, respectively. The 1-, 3-, 5-, 7-and 9-year rates of mitral re-intervention-free survival were 98.8 ± 1.2%, 97.5 ± 1.7%, 92.1 ± 3.1%, 85.5 ± 4.5%, and 85.5 ± 4.5%, respectively. The median time to mitral re-intervention was 6.2 years. Patients who required mitral re-intervention during follow-up were younger (43.3 vs. 51.2 years, p=0.04) and had higher pre-and post-PMV mitral gradient (14.9 vs. 11.5 mmHg, p=0.02 and 6.4 vs. 2.1 mmHg, p<0.001) and higher post-PMV mean pulmonary artery pressure (mPAP) (30.0 vs. 23.2 mmHg, p=0.01). In a Cox proportional hazards model, mPAP ≥25 mmHg was the sole predictor of both mitral re-intervention .528], p=0.025) and clinical events .260], p=0.039). PALAVRAS-CHAVEEstenose mitral; Valvuloplastia mitral percutânea; Prognóstico; Pressão média na artéria pulmonar A pressão média na artéria pulmonar após a valvuloplastia mitral percutânea é um preditor de mau prognóstico a longo prazo Resumo Introdução e objetivos: A valvuloplastia mitral percutânea (PMV) é uma opção eficaz para o tratamento da estenose mitral. Contudo, os resultados deste procedimento são baseados em estudos clínicos e ecocardiográficos com tempos de seguimento relativamente curtos. Os objetivos deste estudo são caracterizar uma população de doentes submetidos a PMV, realizar um seguimento clínico de longa duração e determinar os preditores independentes de reintervenção mitral após PMV e de sobrevida livre de eventos. Métodos: Foi estudada uma população de 91 doentes com estenose mitral tratada por PMV e realizou-se um seguimento clínico com a duração média de 99 meses. Foram pré-definidos dois endpoints: reintervenção mitral pós-PMV (PMV ou cirurgia mitral) e um endpoint clínico combinado que incluiu morte de causa cardiovascular, reintervenção mitral e internamento hospitalar por insuficiência cardíaca descompensada. Foi realizado um estudo comparativo entre os doentes que necessi...

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“…• Sucesso: aumento da área valvar ≥ 25% da área inicial e área valvar mitral final ≥ 1,5 cm², na ausência de insuficiência mitral grave [6][7][8][9][10][11] .…”

Section: Definiçõesunclassified

“…• Reestenose ecocardiográfica: área valvar mitral no seguimento tardio, avaliada pela planimetria e/ou pelo tempo de meia pressão (PHT), < 1,5 cm², com perda ≥ 50% do ganho inicial [7][8][9] .…”

Section: Definiçõesunclassified

Valvotomia mitral percutânea: da primeira à terceira dilatação

Gomes¹,

Esteves²,

Braga³

et al. 2009

Rev. Bras. Cardiol. Invasiva

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RESUMOIntrodução: As causas de reestenose pós-valvotomia mitral percutânea dependem principalmente das características da população submetida à técnica. O objetivo deste trabalho foi comparar os resultados imediatos e tardios dos pacientes submetidos a dois ou mais procedimentos de valvotomia mitral percutânea (VMP) a um grupo de pacientes submetidos apenas a uma dilatação para o tratamento da estenose mitral grave. Método: Os pacientes foram divididos em dois grupos: o grupo A incluiu 90 pacientes submetidos a uma primeira VMP e que, em decorrência de reestenose ecocardiográfica e clínica, foram encaminhados a uma segunda intervenção, e 9 pacientes que, pelo mesmo motivo, foram submetidos a um terceiro procedimento; e grupo B, composto de 90 pacientes selecionados por amostra aleatória simples submetidos a apenas uma dilatação, todas com sucesso. As variáveis ecocardiográficas analisadas para comparação dos resultados dentro do mesmo grupo e entre os grupos A e B foram a área valvar mitral (AVM), os gradientes diastólicos máximo (GDM) e médio (GDm), o diâmetro do átrio esquerdo e a incidência de reestenose. Resultados: Nos pacientes do grupo A, a primeira dilatação foi realizada com sucesso em 87 (96,7%) pacientes. Comparativamente, a média das áreas valvares após a primeira dilatação dos pacientes que compõem o grupo A foi menor que a dos pacientes do grupo B (1,97 ± 0,17 cm² vs. 2,10 ± 0,33 cm²; P = 0,011). Em ambos os grupos, não se observou diferença estatisticamente significante, pré e imediatamente após o primeiro procedimento, na redução da média do GDM e do GDm e na média dos diâmetros do átrio esquerdo. Nos pacientes do grupo A, após a segunda valvotomia, os critérios de sucesso foram alcançados em 77 (85,5%) pacientes. A média das áreas valvares, nessa oportunidade, foi menor que após a primeira intervenção (1,83 ± 0,28 cm² vs. 1,97 ± 0,17 cm²; P < 0,005). Ainda dentro desse mesmo grupo, observou-se queda significativa do GDM e do GDm quando comparados os valores após o primeiro e o segundo procedimentos. Uma ABSTRACT Percutaneous Mitral Balloon Valvotomy: from the First to Third DilatationBackground: The causes for restenosis following percutaneous balloon mitral valvotomy (PBMV) vary according to the population undergoing this technique. The aim of this study was to compare the immediate and long-term results of patients undergoing a second and third PBMV to patients submitted to a single dilatation of the mitral valve for the treatment of severe mitral stenosis. Methods: Patients were divided into two groups: group A with 90 patients who, due to clinical and echocardiographic restenosis, were submitted to more than one procedure, and group B with 90 patients, selected by a random sample who underwent a single successful procedure. The echocardiographic variables analyzed to compare the results in the same group and between groups A and B were mitral valve area (MVA), maximal and mean diastolic gradients, left atrial diameter and incidence and time to restenosis. Results: In group A, the first dilat...

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Follow-up of patients undergoing percutaneous mitral balloon valvotomy. Analysis of factors determining restenosis.

Abstract: This study reports the clinical follow-up (13±1 months) of 100 consecutive patients who underwent percutaneous mitral balloon valvotomy (PMV). Echocardiographic (n=32) and cardiac catheterization (n=37) data from this group are also included.

Cited by 251 publications

References 21 publications

Should we wait until severe pulmonary hypertension develops? Efficacy of percutaneous mitral balloon valvuloplasty in patients with severe pulmonary hypertension: A subgroup analysis of our experience

Should we wait until severe pulmonary hypertension develops? Efficacy of percutaneous mitral balloon valvuloplasty in patients with severe pulmonary hypertension: A subgroup analysis of our experience

Mean pulmonary arterial pressure after percutaneous mitral valvuloplasty predicts long-term adverse outcomes

Valvotomia mitral percutânea: da primeira à terceira dilatação

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