PMID- 10968304
OWN - NLM
STAT- MEDLINE
DCOM- 20000920
LR  - 20190709
IS  - 0002-8614 (Print)
IS  - 0002-8614 (Linking)
VI  - 48
IP  - 8
DP  - 2000 Aug
TI  - Mitral balloon valvotomy for the treatment of mitral stenosis in octogenarians.
PG  - 971-4
AB  - OBJECTIVES: To study the safety and benefit of mitral balloon valvotomy (MBV) in 
      patients aged > or =80 years. SETTING: A tertiary cardiac centre DESIGN: A 
      retrospective study of 20 octogenarians (mean age 83, range 80-89 years) in whom 
      percutaneous MBV was performed as a definitive or palliative treatment for severe 
      mitral stenosis. All were in New York Heart Association (NYHA) symptom class III 
      or IV. Fourteen had been judged unfit for cardiac surgery. Hemodynamic data was 
      recorded before and after MBV. Symptomatic outcome was documented at 1 month for 
      all patients. Outcome at 1 year was available for 16 patients. RESULTS: 
      Dilatation of the mitral valve was achieved in all patients without major 
      complications. Mean mitral valve area increased 106% from 0.81 (+/-0.3) to 1.67 
      (+/- 0.8) cm2, transvalvular gradient decreased from 11.8 (+/- 4.8) to 5.6 
      (+/-2.9) mm Hg, cardiac output increased from 3.1 (+/- 0.6) to 4.1 (+/- 1.4) 
      l/min (all P<.01). Eight of these 20 patients obtained a valve area > or =1.5 
      cm2, and 16 obtained an area > or = 1.2 cm2. One month after BMV, all patients 
      were alive, and 16 of the 20 patients were improved by at least one NYHA class. 
      This improvement was sustained in 7 of 16 patients followed up for 1 year. More 
      severe mitral valve degenerative change, determined by echocardiography, was 
      associated with poorer outcome. CONCLUSIONS: In this group of very old and frail 
      patients, MBV was safe and resulted in significant immediate improvement. 
      Sustained symptomatic benefit at 1 year was obtained in those with less extensive 
      leaflet and subvalvular disease. In patients with severe degenerative valve 
      disease on echocardiography, but unacceptable surgical risk, MBV offers 
      short-term palliation.
FAU - Sutaria, N
AU  - Sutaria N
AD  - Cardiology Department, Western General Hospital, Edinburgh, Scotland.
FAU - Elder, A T
AU  - Elder AT
FAU - Shaw, T R
AU  - Shaw TR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Geriatr Soc
JT  - Journal of the American Geriatrics Society
JID - 7503062
SB  - IM
MH  - Activities of Daily Living
MH  - Aged
MH  - Aged, 80 and over
MH  - *Catheterization/adverse effects/methods
MH  - Comorbidity
MH  - Echocardiography
MH  - Female
MH  - *Frail Elderly
MH  - Geriatric Assessment
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Mitral Valve Stenosis/classification/diagnostic imaging/physiopathology/*therapy
MH  - Patient Selection
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2000/09/01 11:00
MHDA- 2000/09/23 11:01
CRDT- 2000/09/01 11:00
PHST- 2000/09/01 11:00 [pubmed]
PHST- 2000/09/23 11:01 [medline]
PHST- 2000/09/01 11:00 [entrez]
AID - 10.1111/j.1532-5415.2000.tb06897.x [doi]
PST - ppublish
SO  - J Am Geriatr Soc. 2000 Aug;48(8):971-4. doi: 10.1111/j.1532-5415.2000.tb06897.x.