PMID- 10520804
OWN - NLM
STAT- MEDLINE
DCOM- 19991027
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 34
IP  - 4
DP  - 1999 Oct
TI  - Mitral balloon valvotomy for patients with mitral stenosis in atrial 
      fibrillation: immediate and long-term results.
PG  - 1145-52
AB  - OBJECTIVES: The purpose of this study was to examine the effect of atrial 
      fibrillation (AF) on the immediate and long-term outcome of patients undergoing 
      percutaneous mitral balloon valvuloplasty (PMV). BACKGROUND: There is controversy 
      as to whether the presence of AF has a direct negative effect on the outcome 
      after PMV. METHODS: The immediate procedural and the long-term clinical outcome 
      after PMV of 355 patients with AF were prospectively collected and compared with 
      those of 379 patients in normal sinus rhythm (NSR). RESULTS: Patients with AF 
      were older (62 +/- 12 vs. 48 +/- 14 years; p < 0.0001) and presented more 
      frequently with New York Heart Association (NYHA) class IV (18.3% vs. 7.9%; p < 
      0.0001), echocardiographic score >8 (40.1% vs. 25.1%; p < 0.0001), calcified 
      valves under fluoroscopy (32.4% vs. 18.8%, p < 0.0001) and with history of 
      previous surgical commissurotomy (21.7% vs. 16.4%; p = 0.0002). In patients with 
      AF, PMV resulted in inferior immediate and long-term outcomes, as reflected in a 
      smaller post-PMV mitral valve area (1.7 +/- 0.7 vs. 2 +/- 0.7 cm2; p < 0.0001) 
      and a lower event free survival (freedom of death, redo-PMV and mitral valve 
      surgery) at a mean follow-up time of 60 months (32% vs. 61%; p < 0.0001). In the 
      group of patients in AF, severe post-PMV mitral regurgitation (> or =3+) (p = 
      0.0001), echocardiographic score >8 (p = 0.004) and pre-PMV NYHA class IV (p = 
      0.046) were identified as independent predictors of combined events at follow-up. 
      CONCLUSIONS: Patients with AF have a worse immediate and long-term outcomes after 
      PMV. However, the presence of AF by itself does not unfavorably influence the 
      outcome, but is a marker for clinical and morphologic features associated with 
      inferior results after PMV.
FAU - Leon, M N
AU  - Leon MN
AD  - Department of Medicine, Massachusetts General Hospital, and Harvard Medical 
      School, Boston 02114, USA.
FAU - Harrell, L C
AU  - Harrell LC
FAU - Simosa, H F
AU  - Simosa HF
FAU - Mahdi, N A
AU  - Mahdi NA
FAU - Pathan, A
AU  - Pathan A
FAU - Lopez-Cuellar, J
AU  - Lopez-Cuellar J
FAU - Inglessis, I
AU  - Inglessis I
FAU - Moreno, P R
AU  - Moreno PR
FAU - Palacios, I F
AU  - Palacios IF
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - Atrial Fibrillation/mortality/physiopathology/*therapy
MH  - *Catheterization
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Stenosis/mortality/physiopathology/*therapy
MH  - Prospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 1999/10/16 00:00
MHDA- 1999/10/16 00:01
CRDT- 1999/10/16 00:00
PHST- 1999/10/16 00:00 [pubmed]
PHST- 1999/10/16 00:01 [medline]
PHST- 1999/10/16 00:00 [entrez]
AID - S0735-1097(99)00310-1 [pii]
AID - 10.1016/s0735-1097(99)00310-1 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1999 Oct;34(4):1145-52. doi: 10.1016/s0735-1097(99)00310-1.