Immediate and long-Term Results of Percutaneous Mitral Valvuloplasty Using the Inoue Balloon

Jin, Eun Sun; Lee, Yeon Ah; Chon, Suk; Kim, Hyun Sook; Jung, Seung Mook; Park, Sang Sun; Choi, Rak Kyoung; Leem, Dal Su; Hong, Seok Geon; Hwang, Hweung Kon

Abstract

BACKGROUND AND OBJECTIVES
The objective of this study was to assess the short- and long-term clinical outcomes and valvular changes after percutaneous mitral valvuloplasty (PMV) in Sejong Hospital.
SUBJECTS AND METHOD
Four hundred sixty-seven patients received PMV (Ed-already defined above) using the Inoue Balloon at Sejong hospital from 1990 to 2002. Short and long-term results, restenosis-free survival rate and prognostic factors for each result were analyzed by Chi-square, Cox regression analysis, Life table method and Cox proportional hazard model.
RESULTS
After PMV, mitral valve area increased from 0.94+/-0.21 cm2 to 1.76+/-0.37 cm2 and the success rate (MVA>1.5 cm2 or increased by at least 50% without the development of moderate to severe mitral regurgitation) was 78.9%. Age (< or =50 years, p=0.018), echo score (< or =9, p=0.05) and pre-procedural mitral valve area (MVA, > or =1.1 cm2, p=0.001) were independent favorable prognostic factors for short-term result. As for the development of moderate to severe mitral regurgitation, pre-procedural MVA (< or =1.0 cm2, p=0.031) and echo score (>9, p=0.043) were independent predictive factors. Median restenosis-free survival was 82.98 months and the restenosis-free survival rate was 70.9% at 3 years post-PMV, 48.1% at 6 years and 29.6% at 10 years. The independent prognostic factor for restenosis-free survival rate was left atrial dimension (LAD< or =60 mm, p=0.015). In addition, echo score (< or =8, p=0.412), pre-procedural MVA (> or =1.0 cm2, p=0.24) and ejection fraction (EF> or =55%, p=0.146) had an effect on the good long-term results of PMV from multivariate analysis.
CONCLUSION
PMV was a very successful treatment method for mitral stenosis. Pre-procedural MVA was a representative predictive factor for short and long-term outcomes and the development of mitral regurgitation.