PMID- 10385502
OWN - NLM
STAT- MEDLINE
DCOM- 19990716
LR  - 20190623
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 99
IP  - 25
DP  - 1999 Jun 29
TI  - Late results of percutaneous mitral commissurotomy in a series of 1024 patients. 
      Analysis of late clinical deterioration: frequency, anatomic findings, and 
      predictive factors.
PG  - 3272-8
AB  - BACKGROUND: The optimal use of percutaneous mitral commissurotomy (PMC) in a wide 
      range of patients requires accurate evaluation of late results and identification 
      of their predictors. METHODS AND RESULTS: Late results of PMC were assessed in 
      1024 patients whose mean age was 49+/-14 years. Echocardiography showed that 141 
      patients (14%) had pliable valves and mild subvalvular disease, 569 (55%) had 
      extensive subvalvular disease, and 314 (31%) had calcified valves. A single 
      balloon was used in 26 patients, a double balloon in 390, and the Inoue Balloon 
      in 608. Good immediate results were defined as valve area >/=1.5 cm2 without 
      regurgitation >2/4 (Sellers' grade) and were obtained in 912 patients. Median 
      duration of follow-up was 49 months. The 10-year actuarial rate of good 
      functional results (survival with no cardiovascular death and no need for surgery 
      or repeat dilatation and in New York Heart Association [NYHA] class I or II) was 
      56+/-4% in the entire population. Follow-up echocardiography was available in 90% 
      of the patients who experienced poor functional results after good immediate 
      results and showed restenosis in 97% of these. In multivariate analysis, the 
      predictors of poor functional results were old age (P=0.0008), unfavorable valve 
      anatomy (P=0.003), high NYHA class (P<0.0001), atrial fibrillation (P<0.0001), 
      low valve area after PMC (P=0.001), high gradient after PMC (P<0.0001), and grade 
      2 mitral regurgitation after PMC (P=0.04). CONCLUSIONS: PMC can be performed with 
      good late results in a variety of patient subsets. Prediction of late events is 
      multifactorial. Knowledge of these predictors can improve patient selection and 
      follow-up.
FAU - Iung, B
AU  - Iung B
AD  - Cardiology Department, Tenon Hospital, Paris, France.
FAU - Garbarz, E
AU  - Garbarz E
FAU - Michaud, P
AU  - Michaud P
FAU - Helou, S
AU  - Helou S
FAU - Farah, B
AU  - Farah B
FAU - Berdah, P
AU  - Berdah P
FAU - Michel, P L
AU  - Michel PL
FAU - Cormier, B
AU  - Cormier B
FAU - Vahanian, A
AU  - Vahanian A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
CIN - Circulation. 2000 Jul 11;102(2):E18. PMID: 10889145
MH  - Adult
MH  - *Catheterization
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Stenosis/*physiopathology/*therapy
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Recurrence
MH  - Risk
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 1999/06/29 00:00
MHDA- 1999/06/29 00:01
CRDT- 1999/06/29 00:00
PHST- 1999/06/29 00:00 [pubmed]
PHST- 1999/06/29 00:01 [medline]
PHST- 1999/06/29 00:00 [entrez]
AID - 10.1161/01.cir.99.25.3272 [doi]
PST - ppublish
SO  - Circulation. 1999 Jun 29;99(25):3272-8. doi: 10.1161/01.cir.99.25.3272.