The Prediction of Successful Outcome after Percutaneous Mitral Valvuloplasty

Kim, Young Hak; Kang, Duk Hyun; Song, Jae Kwan; Hong, Myeong Ki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung; Song, Hyun

Abstract

BACKGROUND
Several predictor of successful outcome after percutaneous mitral valvuloplasty(PMV) have been identified but the results were controversial. We analyzes the clinical and echocardiographic predictors of successful outcome after PMV. METHOD: We studied 214 patients(167 women and 47 men) undergoing PMV from October 1991 to December 1995. Echocardiographic evaluation was performed before and after PMV. RESULT: The study population had mean age of 41+/-11years, and the total echocardiographic score was 7.5+/-1.5. PMV using Inoue balloon and double balloon technique were performed in 113cases and 101 cases respectively. The successful outcome from PMV(defindedas mitral valve area > or =1.5cm2 and increase in valve area >+25% and less than grade 3 mitral regurgitation(MR)) was achieved in 178 cases(83.2%). The mean mitral valve area was increased from 0.90+/-0.21cm2 to 1.82+/-0.34cm2(p<0.01). The successful outcome group had good echocardiographic score(7.3+/-1.4 vs. 8.8+/-1.4, p<0.01) and larger valve area before procedure(0.92+/-0.21cm2 vs. o.75+/-0.17cm2, p<0.01) than suboptimal result group. The patients with total echocardiographic score <=8 had more increment in valve area after PMV(0.97+/-0.21cm2) than those with total echocardiographic score >8(0.83+/-0.22cm2, p<0.01). Significant MR(>=grade 3 MR) after PMV was developed in 10 cases(4.7%). In patients with significant MR afterPMV, echocardiographic calcification score were high(2.3+/-0.8 vs. 1.7+/-0.7, p<0.01) and mitral valve area before PMV were smaller(0.82+/-0.10cm2 vs. 0.90+/-0.22cm2, p<0.05) than in those without significant MR.
CONCLUSIONS
The predictors of successful outcome after PMV are large mitral valve area and good echocardiographic score. The predictors of significant MR is severe calcified mitral valveand small mitral valve area before PMV.