Predictors of Long-Term Outcomes of Percutaneous Mitral Valvuloplasty in Patients with Rheumatic Mitral Stenosis.
10.3349/ymj.2018.59.2.273
- Author:
Darae KIM
1
;
Hyemoon CHUNG
;
Jong Ho NAM
;
Dong Hyuk PARK
;
Chi Young SHIM
;
Jung Sun KIM
;
Hyuk Jae CHANG
;
Geu Ru HONG
;
Jong Won HA
Author Information
1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. GRHONG@yuhs.ac
- Publication Type:Original Article
- Keywords:
Mitral stenosis;
percutaneous mitral balloon valvuloplasty;
outcome
- MeSH:
Adult;
*Catheterization;
Echocardiography;
Female;
Follow-Up Studies;
Humans;
Kaplan-Meier Estimate;
Male;
Mitral Valve Stenosis/diagnostic imaging/*surgery;
Multivariate Analysis;
Proportional Hazards Models;
Republic of Korea;
Time Factors;
Treatment Outcome
- From:Yonsei Medical Journal
2018;59(2):273-278
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We determined factors associated with long-term outcomes of patients who underwent successful percutaneous mitral balloon valvuloplasty (PMV). MATERIALS AND METHODS: Between August 1980 and May 2013, 1187 patients underwent PMV at Severance Hospital, Seoul, Korea. A total of 742 patients who underwent regular clinic visits for more than 10 years were retrospectively analyzed. The endpoints consisted of repeated PMV, mitral valve (MV) surgery, and cardiovascular-related death. RESULTS: The optimal result, defined as a post-PMV mitral valve area (MVA) >1.5 cm² and mitral regurgitation ≤Grade II, was obtained in 631 (85%) patients. Over a mean follow up duration of 214±50 months, 54 (7.3%) patients underwent repeat PMV, 4 (0.5%) underwent trido-PMV, and 248 (33.4%) underwent MV surgery. A total of 33 patients (4.4%) had stroke, and 35 (4.7%) patients died from cardiovascular-related reasons. In a multivariate analysis, echocardiographic score [p=0.003, hazard ratio=1.56, 95% confidence interval (CI): 1.01–2.41] and post-MVA cut-off (p < 0.001, relative risk=0.39, 95% CI: 0.37–0.69) were the only significant predictors of long-term clinical outcomes after adjusting for confounding variables. A post-MVA cut-off value of 1.76 cm² showed satisfactory predictive power for poor long-term clinical outcomes. CONCLUSION: In this long-term follow up study (up to 20 years), an echocardiographic score >8 and post-MVA ≤1.76 cm² were independent predictors of poor long-term clinical outcomes after PMV, including MV reintervention, stroke, and cardiovascular-related death.
