PMID- 23624488
OWN - NLM
STAT- MEDLINE
DCOM- 20140131
LR  - 20130819
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 99
IP  - 18
DP  - 2013 Sep
TI  - Long-term efficacy of percutaneous mitral commissurotomy for restenosis after 
      previous mitral commissurotomy.
PG  - 1336-41
LID - 10.1136/heartjnl-2013-303944 [doi]
AB  - OBJECTIVE: We analysed long-term results of percutaneous mitral commissurotomy 
      (PMC) performed because of mitral restenosis after previous commissurotomy. 
      DESIGN: Follow-up of a prospective cohort. SETTING: Tertiary university hospital. 
      PATIENTS: We studied 163 consecutive patients who underwent PMC because of 
      restenosis occurring 16 +/- 8 years after previous commissurotomy (closed-heart in 
      121, open-heart in 30 and PMC in 12). Mean age was 48 +/- 14 years; 62 patients 
      (38%) had valve calcification. Restenosis was due to bicommissural fusion in all 
      cases. INTERVENTION: PMC using a single or double balloon in 80 patients and the 
      Inoue balloon in 83. RESULTS: Good immediate results (IR) (valve area >/= 1.5 cm2 
      with MR </= 2/4) were obtained in 135 pts (83%). 20-year rates were 27.9 +/- 4.7% for 
      cardiovascular survival without mitral surgery and 14.8 +/- 3.9% for good 
      functional results (cardiovascular survival without reintervention on the mitral 
      valve and in New York Heart Association (NYHA) class I or II). After good IR, 
      20-year rates were 33.2 +/- 5.5% for cardiovascular survival without surgery and 
      17.9 +/- 4.7% for good functional results. After good IR, multivariate predictive 
      factors of poor late functional results were higher NYHA class (p = 0.01), atrial 
      fibrillation (p = 0.0002) and higher mean mitral gradient after PMC (p = 0.004). 
      CONCLUSIONS: In patients with restenosis after mitral commissurotomy, PMC 
      provides good IR in most cases. After good IR, one patient out of three remains 
      free from surgery and one out of five has good functional results at 20 years. 
      These findings support the use of PMC after previous commissurotomy, particularly 
      in selected patients with few symptoms and in sinus rhythm.
FAU - Bouleti, Claire
AU  - Bouleti C
AD  - Cardiology Department, AP-HP, Bichat University Hospital, Paris, France.
FAU - Iung, Bernard
AU  - Iung B
FAU - Himbert, Dominique
AU  - Himbert D
FAU - Brochet, Eric
AU  - Brochet E
FAU - Messika-Zeitoun, David
AU  - Messika-Zeitoun D
FAU - Detaint, Delphine
AU  - Detaint D
FAU - Garbarz, Eric
AU  - Garbarz E
FAU - Cormier, Bertrand
AU  - Cormier B
FAU - Vahanian, Alec
AU  - Vahanian A
LA  - eng
PT  - Journal Article
DEP - 20130427
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Stenosis/mortality/*surgery
MH  - *Percutaneous Coronary Intervention
MH  - Reoperation
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/04/30 06:00
MHDA- 2014/02/01 06:00
CRDT- 2013/04/30 06:00
PHST- 2013/04/30 06:00 [entrez]
PHST- 2013/04/30 06:00 [pubmed]
PHST- 2014/02/01 06:00 [medline]
AID - heartjnl-2013-303944 [pii]
AID - 10.1136/heartjnl-2013-303944 [doi]
PST - ppublish
SO  - Heart. 2013 Sep;99(18):1336-41. doi: 10.1136/heartjnl-2013-303944. Epub 2013 Apr 
      27.