Long-term (36–63 month) clinical and echocardiographic follow-up after Inoue balloon mitral commissurotomy
✍ Scribed by Lau, Kean-Wah ;Ding, Zee-Pin ;Quek, Susan ;Kwok, Veronica ;Hung, Jui-Sung
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 47 KB
- Volume
- 43
- Category
- Article
- ISSN
- 0098-6569
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✦ Synopsis
Although Inoue balloon mitral commissurotomy (BMC) offers excellent short-term results, there remains a paucity of data on its long-term (H3 yr) outcome. We therefore analyzed the outcome of 68 consecutive patients who had regular long-term clinical and serial echocardiographic follow-up of H3 yr after successful BMC. The procedure provided significant improvements in transmitral valve gradient (13 ؎ 6 mmHg before to 5 ؎ 2 mmHg after BMC, P ؍ 0.0001), left atrial pressure (21 ؎ 6 mmHg before to 14 ؎ 5 mmHg after BMC, P ؍ 0.0001), and mitral valve area (0.8 ؎ 0.2 cm 2 before to 1.7 ؎ 0.4 cm 2 after BMC, P ؍ 0.0001) without incurring G grade 2؉ angiographic mitral regurgitation. At a mean follow-up of 44 ؎ 9 mos (range, 36-63 mo), functional benefits were maintained in 91% of patients. Serial echocardiographic evaluations performed in 97% of patients revealed a restenosis rate of 15% (defined as a loss of G50% initial gain in valve area or a valve area of F1.5 cm 2 ). No strokes or deaths were encountered. Of the 15 clinical, echocardiographic, and procedural variables analyzed in a multivariate model, only the presence of chronic atrial fibrillation was an independent correlate of restenosis (P F 0.05). It was clearly more common in patients with than those without restenosis (100% with vs. 57%, respectively, P ؍ 0.009). In conclusion, our study shows that BMC confers maintained long-term functional benefits and a low anatomic restenosis rate H3 yr after BMC.