Left ventriculography (LVG) was performed to assess severity of mitral regurgitation (MR) on a scale of 0-4+ in 157 patients before and immediately after percutaneous mitral balloon valvotomy (PMV). There were 129 women and 28 men aged 51 f 1 (range 13-87) yr. With PMV, mitral valve area increased from 0.9 f 0.1 cm2 to 2.0 f 0.1 cm2 (P < .OOOl).
Increase in mitral regurgitation (MR) occurred in 69 patients (44%). Patients were divided into two groups based on increase in MR after PMV. Group A (n = 136) had 0-1 + increase in MR. Group B (n = 20) had 2 2 + increase in MR after PMV. The only predictor of increase in MR22+ was the ratio of effective balloon dilating area to body surface area (EBDN BSA). EBDNBSA was 4.0 f 0.1 cm2/mz in Group A vs. 4.37 f 0.2 cm2/m2 in Group B Follow-up of patients in Group B showed: Four patients remained NYHA Class 111 and required mitral valve replacement 4.3 f 1.1 (range 5-21) mo after PMV. One patient who had undergone combined aortic and mitral valvotomy died in the hospital of worsening heart failure. One patient died 1 mo later of sepsis related to a dental abscess. Follow-up of the remaining 14 patients at 9.5 f 1.1 (range 2-7) mo showed 10 in NYHA Class I and four in NYHA Class II. Eight of 15 patients (53%) who had repeat left ventriculogram at 9.0 f 0.8 mo after PMV had a decrease in MR of one grade when compared to LVG immediately after PMV.