Assuntos
Aterosclerose/diagnóstico por imagem , Ponte de Artéria Coronária , Oclusão de Enxerto Vascular/diagnóstico por imagem , Veia Safena/transplante , Idoso , Ponte de Artéria Coronária/efeitos adversos , Rejeição de Enxerto/etiologia , Humanos , Masculino , Veia Safena/diagnóstico por imagem , Tomografia de Coerência Óptica , Falha de TratamentoRESUMO
Background: Mitral balloon valvuloplasty (MBV) is the therapy of choice for the treatment of symptomatic mitral stenosis with suitable anatomy. Although its short and mid-term results are favorable, there is a paucity of information about long-term follow-up. Aim: To assess the late results of MBV. Material and Methods: A cohort of 225 patients aged 8 to 20 years who were subjected to a MBV from 1989 to 2001, was studied. All variables at the time of the procedure, short and long-term results and major events during follow-up (new mitral intervention and mortality) were recorded. Uni and multivariate analysis were used to assess prognosis. Results: The mean follow-up lapse was 13.5 years (range 8 to 20 years). During this period, 88 patients (39.1%) remained event-free and in acceptable functional capacity. Eight percent died, 8% required a second MBV and 43.5% required a surgical mitral valve replacement. A post-procedural area equal or greater to 1.9 cm² was associated with a greater likelihood of free-event survival (log rank test: p = 0.02/Cox proportional regression model: coefficient 0.54, p = 0.04). Conclusions: MBV is effective, although there is a high chance of new interventions in the long-term follow-up. A larger post-procedure mitral area is associated with a better prognosis.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valvuloplastia com Balão/métodos , Estenose da Valva Mitral/cirurgia , Fatores Etários , Valvuloplastia com Balão/mortalidade , Métodos Epidemiológicos , Estenose da Valva Mitral/mortalidade , Estenose da Valva Mitral , Valva Mitral/cirurgia , Valva Mitral , Complicações Pós-Operatórias , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Mitral balloon valvuloplasty (MBV) is the therapy of choice for the treatment of symptomatic mitral stenosis with suitable anatomy. Although its short and mid-term results are favorable, there is a paucity of information about long-term follow-up. AIM: To assess the late results of MBV. MATERIAL AND METHODS: A cohort of 225 patients aged 8 to 20 years who were subjected to a MBV from 1989 to 2001, was studied. All variables at the time of the procedure, short and long-term results and major events during follow-up (new mitral intervention and mortality) were recorded. Uni and multivariate analysis were used to assess prognosis. RESULTS: The mean follow-up lapse was 13.5 years (range 8 to 20 years). During this period, 88 patients (39.1%) remained event-free and in acceptable functional capacity. Eight percent died, 8% required a second MBV and 43.5% required a surgical mitral valve replacement. A post-procedural area equal or greater to 1.9 cm² was associated with a greater likelihood of free-event survival (log rank test: p = 0.02/Cox proportional regression model: coefficient 0.54, p = 0.04). CONCLUSIONS: MBV is effective, although there is a high chance of new interventions in the long-term follow-up. A larger post-procedure mitral area is associated with a better prognosis.
