Which Patients Benefit From Percutaneous Mitral Balloon Valvuloplasty?

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Abstract
Background — Percutaneous mitral balloon valvuloplasty (PMV) results in good immediate results, particularly in patients with echocardiographic scores (Echo-Sc) ≤8. However, which variables relate to long-term outcome is unclear. Methods and Results — We report the immediate and long-term clinical follow-up (mean, 4.2±3.7 years; range, 0.5 to 15) of 879 patients who underwent 939 PMV procedures. Patients were divided into 2 groups, Echo-Sc ≤8 (n=601) and Echo-Sc >8 (n=278). PMV resulted in an increase in mitral valve area from 1.0±0.3 to 2.0±0.6 cm 2 in patients with Echo-Sc ≤8 and from 0.8±0.3 to 1.6±0.6 cm 2 in patients with Echo-Sc >8 ( P P 8, age, prior surgical commissurotomy, NYHA functional class IV, pre-PMV mitral regurgitation ≥2+, and higher post-PMV pulmonary artery pressure as independent predictors of combined events at long-term follow-up. Conclusions — The immediate and long-term outcome of patients undergoing PMV is multifactorial. The use of the Echo-Sc in conjunction with other clinical and morphological predictors of PMV outcome allows identification of patients who will obtain the best outcome from PMV.

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