Long-term results of percutaneous mitral valvuloplasty with the Inoue balloon catheter

Chen, Chuan-Rong; Cheng, Tsung O.; Chen, Jiyan; Zhou, Yingling; Jia, Ming; Ma, Tiezheng

doi:10.1016/0002-9149(92)90297-c

Cited by 75 publications

(34 citation statements)

References 16 publications

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“…Four years after percutaneous mitral balloon valvotomy, 79·2% of patients were still in NYHA class I or II, and in 70·8% the improvement in NYHA class had been maintained compared to that pre-percutaneous mitral balloon valvotomy. This is comparable to data from others [6][7][8]10,17] . In addition, the improvement in mitral valve area continued during follow-up.…”

Section: Follow-upsupporting

confidence: 91%

“…After 4 years, the decrease in mitral valve area had reached a clinically insignificant 1·8 cm 2 , from 2·0 cm 2 immediately after percutaneous mitral balloon valvotomy. This is the same change as that found by Chen et al, who had a follow-up period of 5 years [7] . Another report from these authors [11] described a decrease in mitral valve area from 2·0 cm 2 immediately after percutaneous mitral balloon valvotomy to 1·7 cm 2 after 8 years' follow-up.…”

Section: Follow-upsupporting

confidence: 84%

“…Data, appear to be favourable in both the short-and long-term [6][7][8][9][10][11] . However published long-term results do not indicate the occurrence of events or restenosis during follow-up.…”

Section: Introductionmentioning

confidence: 96%

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Predictors of clinical events or restenosis during follow-up after percutaneous mitral balloon valvotomy

Langerveld

Plokker

Ernst

et al. 1999

European Heart Journal

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Aims The purpose of this study is to define predictors of events or restenosis during follow-up after percutaneous mitral balloon valvotomy. Methods and ResultsPercutaneous mitral balloon valvotomy was attempted in 137 patients with severe mitral valve stenosis. In 127 patients follow-up was complete with a mean of 4·2 2·6 years. Events during follow-up were defined as death, mitral valve surgery or repeat percutaneous mitral balloon valvotomy. Restenosis was defined as a decrease in mitral valve area from d1·5 cm 2 following percutaneous mitral balloon valvotomy to <1·5 cm 2 . There was 80 4% event-free survival 4 years after percutaneous mitral balloon valvotomy. Multivariate analysis showed chronic atrial fibrillation at baseline (P=0·039, relative risk (RR)=2·5) and a high residual maximal gradient after percutaneous mitral balloon valvotomy (P=0·004, RR=2·0 per 5 mmHg) to be independent predictors of an event during follow-up. The restenosis rate was 28·3% after 4 years. Chronic atrial fibrillation at baseline (P=0·0338, RR=2·2), a small mitral valve area after percutaneous mitral balloon valvotomy (P=0·0003, RR=0·8/0·1 cm 2 ) and a high residual maximal transmitral gradient (P=0·0252, RR=1·6/5 mmHg) were all independent predictors of restenosis. ConclusionPatients with chronic atrial fibrillation and a high maximal transmitral gradient after percutaneous mitral balloon valvotomy have a higher risk for events during follow-up. Restenosis is related to the presence of chronic atrial fibrillation at baseline and a suboptimal percutaneous mitral balloon valvotomy result.

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Section: Follow-upsupporting

confidence: 91%

Section: Follow-upsupporting

confidence: 84%

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Predictors of clinical events or restenosis during follow-up after percutaneous mitral balloon valvotomy

Langerveld

Plokker

Ernst

et al. 1999

European Heart Journal

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“…4,23,[34][35][36] Studies that reported a low restenosis rate (2-6%) were targeting a young (<40 years) population with pliable valves. 25,35,36 Such studies also reported results from a relatively short follow-up period (<12 months). In contrast, Desideri et al reported a much higher restenosis rate of 21% during the 19 months follow-up of their population (mean age: 52 years).…”

Section: Restenosis After Ptmcmentioning

confidence: 99%

Long-Term Clinical and Echocardiographic Outcome in Patients With Mitral Stenosis Treated With Percutaneous Transvenous Mitral Commissurotomy

1999

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“…Significant reduction of LA size following successful mitral Valvotomy was demonstrated by several investigators (Takarada et al, 1992;Rittoo et al, 1993;Chen et al, 1992;Stefadouros et al, 1999). To demonstrate the effect of MBV on left atrial size, 205 consecutive patients (mean age 31 ± 11 years) were studied by the author (Stefadouros et al, 1999).…”

Section: Effect Of Mbv On Left Atrial Sizementioning

confidence: 88%

Mitral Balloon Valvuloplasty

1996

European Heart Journal

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Percutaneous mitral balloon valvuloplasty (MBV) was introduced in 1984 by Inoue who developed the procedure as a logical extension of surgical closed commissurotomy. Since then, MBV has emerged as the treatment of choice for severe pliable rheumatic mitral stenosis (MS). With increasing experience and better selection of patient, the immediate results of the procedure have improved and the rate of complications declined. When the reported complications of MBV are viewed in aggregate, complications occur at approximately the following rates: mortality (0-0.5%), cerebral accident (1-2%), mitral regurgitation (MR) requiring surgery (1.6-3%). These complication rates compare favorably to those reported after surgical commissurotomy. Several randomized trials reported similar hemodynamic results with MBV and surgical commissurotomy. Restenosis after MBV ranges from 4% to 70% depending on the patient selection, valve morphology, and duration of follow-up. Restenosis was encountered in 31% of the author's series at mean follow-up 9 ± 5.2 years (range 1.5-19 years) and the 10, 15, and 19 years restenosis-free survival rates were (78 ± 2%) (52 ± 3%) and (26 ± 4%), respectively, and were significantly higher for patients with favorable mitral morphology (MES 6 8) at 88 ± 2%, 67 ± 4% and 40 ± 6%), respectively (P < 0.0001). The 10, 15, and 19 years event-free survival rates were (88 ± 2%, 60 ± 4% and 28 ± 7%, respectively, and were significantly higher for patients with favorable mitral morphology (92 ± 2%, 70 ± 4% and 42 ± 7%, respectively (P < 0.0001). The effect of MBV on severe pulmonary hypertension, concomitant severe tricuspid regurgitation, left ventricular function, left atrial size, and atrial fibrillation are addressed in this review. In addition, the application of MBV in specific clinical situations such as in children, during pregnancy and for restenosis is discussed.

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Long-term results of percutaneous mitral valvuloplasty with the Inoue balloon catheter

Cited by 75 publications

References 16 publications

Predictors of clinical events or restenosis during follow-up after percutaneous mitral balloon valvotomy

Predictors of clinical events or restenosis during follow-up after percutaneous mitral balloon valvotomy

Long-Term Clinical and Echocardiographic Outcome in Patients With Mitral Stenosis Treated With Percutaneous Transvenous Mitral Commissurotomy

Mitral Balloon Valvuloplasty

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