Very Long Term Follow-Up After Percutaneous Balloon Mitral Valvuloplasty
JACC cardiovasc. interv
; 11(19): 1945-1952, Oct. 2018. tab, graf
Article
em En
| SES-SP, CONASS, SESSP-IDPCPROD, SES-SP
| ID: biblio-1222417
Biblioteca responsável:
BR79.1
ABSTRACT
OBJECTIVES:
The aim of this study was to assess very long term outcomes after successful percutaneous balloon mitral valvuloplasty (PBMV).BACKGROUND:
PBMV remains the preferred treatment for patients with severe symptomatic rheumatic mitral stenosis and suitable anatomy.METHODS:
All consecutive patients who underwent successful PBMV between 1987 and 2010 were included. The primary endpoint was the composite of all-cause mortality, need for mitral surgery, or repeat PBMV up to 23 years.RESULTS:
Among all 1,582 consecutive patients undergoing PBMV, acute success was achieved in 90.9% (n»1,438).Independent predictors of acute success included left atrial size (odds ratio 0.96; 95% confidence interval [CI] 0.93 to0.99; p»0.045), Wilkins score#8 (odds ratio 1.66; 95% CI 0.48 to 0.93; p»0.02) and age (odds ratio 0.97; 95% CI0.96 to 0.99; p»0.006). Very long-term follow-up (median 8.3 years, mean 15.6 years) was obtained in 79.1% of successful cases. The incidence of the primary endpoint was 19.1% (95% CI 17.0% to 21.1%). The rates of overall lmortality, need for mitral valve surgery, or repeat PBMV were 0.6% (95% CI 0.3% to 1.2%), 8.3% (95% CI 7.0% to9.9%), and 10.0% (95% CI 8.5% to 11.7%), respectively. On multivariate analysis, New York Heart Association functional class III or IV (hazard ratio 1.62; 95% CI 1.26 to 2.09; p<0.001), higher age (hazard ratio 0.97; 95% CI 0.96 to0.98; p»0.028), and mitral valve area#1.75 cm2after the procedure (hazard ratio 1.67; 95% CI 1.28 to 2.11;p»0.028) were independent predictors of the primary endpoint.CONCLUSIONS:
In very long term follow-up, more than 75% of patients exhibited sustained results. Prediction of late favorable results is multifactorial and strongly determined by age, previous symptoms and post-procedural mitral valve area.(J Am Coll Cardiol Intv 2018;11194552) © 2018 by the American College of Cardiology Foundation.
Texto completo:
1
Coleções:
06-national
/
BR
Base de dados:
CONASS
/
SES-SP
/
SESSP-IDPCPROD
Assunto principal:
Valvuloplastia com Balão
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Valva Mitral
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Estenose da Valva Mitral
Tipo de estudo:
Prognostic_studies
Idioma:
En
Revista:
JACC cardiovasc. interv
Ano de publicação:
2018
Tipo de documento:
Article