Prediction of successful outcome in 130 patients undergoing percutaneous balloon mitral valvotomy.

Abascal, Vivian M.; Wilkins, Gerard T.; O'Shea, John P.; Choong, C.; Palacios, Igor F.; Thomas, James D.; Rosas, Emma; Newell, John; Block, Peter C.; Weyman, Arthur E.

doi:10.1161/01.cir.82.2.448

Cited by 230 publications

(97 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since MS patients with MVA ≥ 1.5 cm 2 are generally considered to have mild stenosis and are relatively asymptomatic, this value was chosen as the threshold for procedural success. 16 Using this definition, we observed a PMV procedural success rate of 82.4%. Other studies, using the same definition, reported success rates ranging from 70 to 90%.…”

Section: Discussionmentioning

confidence: 91%

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)

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionmentioning

confidence: 91%

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)

View full text Add to dashboard Cite

show abstract

“…This hospital based prospective, non-randomized, observational study included 25 patients of symptomatic severe mitral stenosis [defined as NYHA functional class II-IV, mitral valve area (MVA) of ≤ 1 cm 2 by planimetry, pressure half time (PHT) ≥ 220 msec and/or mean diastolic gradient (MDG) of ≥ 10mm Hg], [10][11][12] in normal sinus rhythm, with suitable valve morphology (defined as Wilkins's score < 8, no or mild mitral regurgitation, and no commissural calcification or LA thrombus) 13,14 who underwent a successful BMV (defined as post-procedural MVA of > 1.5cm 2 or > 50% increase from pre-procedural MVA, and no more than moderate mitral regurgitation after the procedure) at our hospital. 15,16 Exclusion criteria included: i.Documented history or peri-procedural` occurrence of AF or any other sustained arrhythmia.…”

Section: Methodsmentioning

confidence: 99%

Acute Impact of Balloon Mitral Valvotomy on Left Atrial Functions in Mitral Stenosis

Beig¹,

Dar²,

Kumar³

et al. 2017

JCDR

View full text Add to dashboard Cite

Background: Rheumatic mitral stenosis (MS) is associated with progressive impairment of left atrial (LA) mechanical functions. This study was conducted to assess the acute impact of Balloon Mitral Valvotomy (BMV) on these functions. Methods: This single centre observational study included 25 patients with severe MS (aged 34.1 ± 7.1 years, with mean mitral valve area of 0.74 ± 0.13 cm²), in sinus rhythm, who underwent successful BMV at our hospital. Phasic LA volumes (V max : maximal LA volume, V min : minimal LA volume, and V p : LA volume at the onset of P-wave) were measured by modified Simpson's method. Parameters of LA reservoir function i.e. LA total emptying fraction (LATEF) and LA expansion index (LAEI); conduit function i.e. LA passive emptying fraction (LAPEF); and pump function i.e. LA active emptying fraction (LAAEF) were calculated from these volumes. All these parameters were evaluated before and 24-48 hours after BMV. Results: Successful BMV led to significant reduction in V max (p < 0.001), V min (p < 0.001), and V p (p < 0.001). There was a significant increase in LATEF (p= 0.001) and LAEI (p= 0.002). LAPEF increased insignificantly (p= 0.057), while there was no significant change in LAAEF (p =0.127) after BMV. Conclusion: Successful BMV leads to early improvement in left atrial reservoir and conduit functions, without significantly affecting left atrial pump function. Whether these acute changes translate into long term left atrial reverse remodelling and clinical benefits thereof needs to be established by further studies.

show abstract

“…(8) A score of <9 in association with no more than mild MR, is associated with a good short term outcome following the procedure. (9,10) The following clinical settings are of interest:…”

Section: Patient Selectionmentioning

confidence: 99%

Percutaneous heart valve interventions: a South African perspective

Weich

Doubell

2017

SAHJ

View full text Add to dashboard Cite

Prediction of successful outcome in 130 patients undergoing percutaneous balloon mitral valvotomy.

Abstract: We studied 130 patients undergoing percutaneous balloon mitral valvotomy. The relation between valvular morphology according to a previously described echocardiographic scoring system and hemodynamic outcome expressed as qualitative ("good" and

Cited by 230 publications

References 17 publications

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

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

Acute Impact of Balloon Mitral Valvotomy on Left Atrial Functions in Mitral Stenosis

Percutaneous heart valve interventions: a South African perspective

Contact Info

Product

Resources

About