Korean Circ J.  2000 Nov;30(11):1395-1403. 10.4070/kcj.2000.30.11.1395.

The Long-term Follow-up Results after Successful Double-Balloon Percutaneous Mitral Commissurotomy

• Lee JH
• Na SH
• Lee MM
• Chae IH
• Kim HS
• Sohn DW
• Oh BH
• Park YB
• Choi YS
• Lee YW

• KMID: 2093771
• DOI: http://doi.org/10.4070/kcj.2000.30.11.1395

Abstract

BACKGROUND AND OBJECTIVES: This study was performed to assess long-term clinical outcome and restenosis rate after percutaneous mitral commissurotomy(PMC) and to identify the predictable factors influencing the clinical outcome and restenosis. METHOD: Patients underwent PMC at Seoul National University Hospital between August, 1988 and January, 1999(total 394 cases, mean follow-up duration: 75+/-32months) were enrolled. Successful PMC is defined as post-PMC mitral valve area(MVA) > or =1.5cm2 or > or =25% increase and MR < or =moderate. Restenosis is defined as MVA <1.5cm2 with > 50% reduction of initial gain. Major clinical events include repeated PMC, mitral valve replacement, stroke, and death.
RESULTS
After PMC mitral valve area increased from 1.01+/-0.33cm2 to 2.23+/-0.89cm2. The 9-year event-free survival rate is 78%. The independent predictors of event-free survival rate are echocardiographic score(p=.0068) and post-PMC pulmonary artery systolic pressure(p=.0255). The 9-year restenosis-free survival rate is 44%. The independent predictors of restenosis-free survival are age(p=.0000), echocardiographic score(p=.0052) and post-PMC left atrial volume(p=.0445). For 10-year follow-up, average MVA loss is 0.24cm2: 0.17cm2 in patent group and 0.34cm2 in restenosis group.
CONCLUSION
Percutaneous mitral commissurotomy as a treatment for patients with mitral stenosis is safe and achieves good long-term results.

MeSH Terms

Disease-Free Survival
Echocardiography
Follow-Up Studies*
Humans
Mitral Valve
Mitral Valve Stenosis
Pulmonary Artery
Seoul
Stroke
Survival Rate