PMID- 29223427
OWN - NLM
STAT- MEDLINE
DCOM- 20171215
LR  - 20171215
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 194
DP  - 2017 Dec
TI  - Late outcome of percutaneous mitral commissurotomy: Randomized comparison of 
      Inoue versus double-balloon technique.
PG  - 1-8
LID - S0002-8703(17)30123-0 [pii]
LID - 10.1016/j.ahj.2017.04.004 [doi]
AB  - BACKGROUND: Late prognosis after successful percutaneous mitral commissurotomy 
      (PMC) is unclear. We compared late results of PMC using Inoue versus 
      double-balloon techniques up to 25 years in a randomized trial. METHODS: Between 
      1989 and 1995, 302 patients (77 men, 41 +/- 11 years) with severe mitral stenosis 
      were randomly assigned to undergo PMC using Inoue (n = 152; group I) or 
      double-balloon technique (n = 150; group D). The end points were the composite 
      events of death, mitral surgery, repeat PMC, or deterioration of New York Heart 
      Association (NYHA) class >/=3. RESULTS: During median follow-up of 20.7 years 
      (maximum, 25.6), clinical events occurred in 82 (53.9%) patients in group I (37 
      deaths, 44 mitral surgeries, 9 repeat PMCs, 3 NYHA class >/=3) and in 79 (52.7%) 
      patients in group D (34 deaths, 51 mitral surgeries, 5 repeat PMCs, 4 NYHA class 
      >/=3). Event-free survival rates at 24 years were not significantly different 
      between group I and group D (40.8% and 42.6%, respectively; hazard ratio [HR], 
      0.88; 95% confidence interval [CI], 0.65-1.20; P = .423). On multivariate 
      analysis, absence of post-PMC commissural mitral regurgitation (MR) (HR, 1.84; 
      95% CI, 1.28-2.63; P = .001) and immediate post-PMC mitral valve area (MVA) <1.8 
      cm(2) (HR, 1.53; 95% CI, 1.04-2.25; P = .031) were independently correlated with 
      clinical events after successful PMC. CONCLUSIONS: The Inoue and double-balloon 
      methods showed similar good clinical outcomes up to 25 years, and the achievement 
      of effective commissurotomy to develop post-PMC commissural MR or immediate 
      post-PMC MVA >/=1.8 cm(2) is important in optimizing the late results of PMC.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Lee, Sahmin
AU  - Lee S
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
FAU - Kang, Duk-Hyun
AU  - Kang DH
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. Electronic 
      address: dhkang@amc.seoul.kr.
FAU - Kim, Dae-Hee
AU  - Kim DH
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
FAU - Song, Jong-Min
AU  - Song JM
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
FAU - Song, Jae-Kwan
AU  - Song JK
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
FAU - Park, Seong-Wook
AU  - Park SW
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
FAU - Park, Seung-Jung
AU  - Park SJ
AD  - Divisions of Cardiology, Asan Medical Center, University of Ulsan College of 
      Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. Electronic 
      address: sjpark@amc.seoul.kr.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170418
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Adult
MH  - Balloon Valvuloplasty/*instrumentation
MH  - Cardiac Catheterization/*methods
MH  - Cardiac Surgical Procedures/*methods
MH  - Disease-Free Survival
MH  - Echocardiography, Doppler
MH  - Equipment Design
MH  - Female
MH  - Follow-Up Studies
MH  - *Forecasting
MH  - Humans
MH  - Male
MH  - Mitral Valve/diagnostic imaging/*surgery
MH  - Mitral Valve Stenosis/diagnosis/*surgery
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2017/12/11 06:00
MHDA- 2017/12/16 06:00
CRDT- 2017/12/11 06:00
PHST- 2017/01/17 00:00 [received]
PHST- 2017/04/11 00:00 [accepted]
PHST- 2017/12/11 06:00 [entrez]
PHST- 2017/12/11 06:00 [pubmed]
PHST- 2017/12/16 06:00 [medline]
AID - S0002-8703(17)30123-0 [pii]
AID - 10.1016/j.ahj.2017.04.004 [doi]
PST - ppublish
SO  - Am Heart J. 2017 Dec;194:1-8. doi: 10.1016/j.ahj.2017.04.004. Epub 2017 Apr 18.