Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon
Percutaneous mitral commissurotomy (PMC) has emerged as an effective nonsurgical technique for the treatment of patients with symptomatic mitral stenosis. This report highlights the immediate and long-term follow-up results of this procedure in an unselected cohort of patients with rheumatic mitral stenosis from a single center. PMC with Inoue balloon was performed in 70 patients in a 2-year period (1993-1994). Age of patients ranged from 18 to 67 years (mean 38 ± 11). Atrial fibrillation was present in 18 (30%) patients. A detailed clinical and echocardiographic (two-dimensional, continuous-wave Doppler and color-flow imaging) assessment was done at follow-up. The procedure was technically successful in 61 (85%) patients with an increase in mitral valve area (MVA) from 0.96 ± 0.2 to 1.7 ± 0.28 cm² (P < .001) and a reduction in mean trans-mitral gradient from 14.3 ± 4.8 to 6.0 ± 2.8 mmHg (P < .01). Mitral regurgitation appeared or worsened in 25 (30%) patients, of which 3 (4%) developed severe mitral regurgitation. Urgent mitral valve replacement was performed in these 3 patients. Data of 52 patients followed over a period of 105 ± 10 months revealed MVA of 1.4 ± 0.4 cm. Elective mitral valve replacement was done in 14 (23%) patients. Mitral restenosis diagnosed with echocardiography was seen in 24 (50%) patients, of which 14 were having recurrence of class III or more symptoms and were treated with surgery. Thus, percutaneous mitral commissurotomy is an effective and safe procedure and over 2/3 of the patients were event-free at the end of follow-up. The benefits are sustained in most of these patients on long-term follow-up.
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Instituto Nacional de Cardiología Ignacio Chávez
2009
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oai:scielo:S1405-994020090001000032010-09-08Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloonLópez-Meneses,MauricioMartínez Ríos,Marco AntonioVargas Barrón,JesúsReyes Corona,JesúsSánchez,Francisco Percutaneous mitral commissurotomy Long term follow-up Mitral stenosis Percutaneous mitral commissurotomy (PMC) has emerged as an effective nonsurgical technique for the treatment of patients with symptomatic mitral stenosis. This report highlights the immediate and long-term follow-up results of this procedure in an unselected cohort of patients with rheumatic mitral stenosis from a single center. PMC with Inoue balloon was performed in 70 patients in a 2-year period (1993-1994). Age of patients ranged from 18 to 67 years (mean 38 ± 11). Atrial fibrillation was present in 18 (30%) patients. A detailed clinical and echocardiographic (two-dimensional, continuous-wave Doppler and color-flow imaging) assessment was done at follow-up. The procedure was technically successful in 61 (85%) patients with an increase in mitral valve area (MVA) from 0.96 ± 0.2 to 1.7 ± 0.28 cm² (P < .001) and a reduction in mean trans-mitral gradient from 14.3 ± 4.8 to 6.0 ± 2.8 mmHg (P < .01). Mitral regurgitation appeared or worsened in 25 (30%) patients, of which 3 (4%) developed severe mitral regurgitation. Urgent mitral valve replacement was performed in these 3 patients. Data of 52 patients followed over a period of 105 ± 10 months revealed MVA of 1.4 ± 0.4 cm. Elective mitral valve replacement was done in 14 (23%) patients. Mitral restenosis diagnosed with echocardiography was seen in 24 (50%) patients, of which 14 were having recurrence of class III or more symptoms and were treated with surgery. Thus, percutaneous mitral commissurotomy is an effective and safe procedure and over 2/3 of the patients were event-free at the end of follow-up. The benefits are sustained in most of these patients on long-term follow-up.info:eu-repo/semantics/openAccessInstituto Nacional de Cardiología Ignacio ChávezArchivos de cardiología de México v.79 n.1 20092009-03-01info:eu-repo/semantics/articletext/htmlhttp://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-99402009000100003en |
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López-Meneses,Mauricio Martínez Ríos,Marco Antonio Vargas Barrón,Jesús Reyes Corona,Jesús Sánchez,Francisco |
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López-Meneses,Mauricio Martínez Ríos,Marco Antonio Vargas Barrón,Jesús Reyes Corona,Jesús Sánchez,Francisco Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon |
author_facet |
López-Meneses,Mauricio Martínez Ríos,Marco Antonio Vargas Barrón,Jesús Reyes Corona,Jesús Sánchez,Francisco |
author_sort |
López-Meneses,Mauricio |
title |
Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon |
title_short |
Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon |
title_full |
Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon |
title_fullStr |
Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon |
title_full_unstemmed |
Ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with Inoue balloon |
title_sort |
ten-year clinical and echocardiographic follow-up of patients undergoing percutaneous mitral commissurotomy with inoue balloon |
description |
Percutaneous mitral commissurotomy (PMC) has emerged as an effective nonsurgical technique for the treatment of patients with symptomatic mitral stenosis. This report highlights the immediate and long-term follow-up results of this procedure in an unselected cohort of patients with rheumatic mitral stenosis from a single center. PMC with Inoue balloon was performed in 70 patients in a 2-year period (1993-1994). Age of patients ranged from 18 to 67 years (mean 38 ± 11). Atrial fibrillation was present in 18 (30%) patients. A detailed clinical and echocardiographic (two-dimensional, continuous-wave Doppler and color-flow imaging) assessment was done at follow-up. The procedure was technically successful in 61 (85%) patients with an increase in mitral valve area (MVA) from 0.96 ± 0.2 to 1.7 ± 0.28 cm² (P < .001) and a reduction in mean trans-mitral gradient from 14.3 ± 4.8 to 6.0 ± 2.8 mmHg (P < .01). Mitral regurgitation appeared or worsened in 25 (30%) patients, of which 3 (4%) developed severe mitral regurgitation. Urgent mitral valve replacement was performed in these 3 patients. Data of 52 patients followed over a period of 105 ± 10 months revealed MVA of 1.4 ± 0.4 cm. Elective mitral valve replacement was done in 14 (23%) patients. Mitral restenosis diagnosed with echocardiography was seen in 24 (50%) patients, of which 14 were having recurrence of class III or more symptoms and were treated with surgery. Thus, percutaneous mitral commissurotomy is an effective and safe procedure and over 2/3 of the patients were event-free at the end of follow-up. The benefits are sustained in most of these patients on long-term follow-up. |
publisher |
Instituto Nacional de Cardiología Ignacio Chávez |
publishDate |
2009 |
url |
http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-99402009000100003 |
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