Late results of percutaneous mitral commissurotomy for calcific mitral stenosis

The aim of this study was to assess late results of percutaneous mitral commissurotomy (PMC) in calcific mitral stenosis and to identify predictors to improve patient selection. We analyzed 422 patients who underwent PMC for calcific mitral stenosis. The extent of calcium was graded from 1 to 4 by f...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of cardiology 2000-06, Vol.85 (11), p.1308-1314
Main Authors: Iung, Bernard, Garbarz, Eric, Doutrelant, Luc, Berdah, Patricia, Michaud, Pierre, Farah, Bruno, Mokhtari, Mourad, Makita, Yasuhiro, Michel, Pierre-Louis, Luxereau, Philippe, Cormier, Bertrand, Vahanian, Alec
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Calcinosis - diagnostic imaging
Calcinosis - mortality
Calcinosis - surgery
Cardiology
Cardiovascular disease
Catheterization
Female
Fluoroscopy
Follow-Up Studies
Health risk assessment
Humans
Male
Mitral Valve - diagnostic imaging
Mitral Valve - surgery
Mitral Valve Stenosis - diagnostic imaging
Mitral Valve Stenosis - mortality
Mitral Valve Stenosis - surgery
Patient Selection
Patients
Postoperative Complications - etiology
Survival Rate
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The aim of this study was to assess late results of percutaneous mitral commissurotomy (PMC) in calcific mitral stenosis and to identify predictors to improve patient selection. We analyzed 422 patients who underwent PMC for calcific mitral stenosis. The extent of calcium was graded from 1 to 4 by fluoroscopy: 227 patients (53%) were graded 1, 125 (30%) graded 2, 55 graded 3 (13%), and 15 graded 4 (4%). The procedure failed in 15 patients, used a single balloon in 11, a double balloon in 126, and the Inoue balloon in 270. In-hospital mortality was 1.2%. Good immediate results (valve area ≥1.5 cm 2 without mitral regurgitation >2/4), were obtained in 321 patients (76%). Multivariate analysis identified 5 predictors of good immediate results: a younger age (p = 0.0004), a lesser degree of stenosis (p = 0.0005), a smaller extent of calcium (p = 0.04), the use of the Inoue balloon (p = 0.015), and a larger effective balloon dilating area (p = 0.006). Good functional results, defined as survival with no further intervention and in New York Heart Association class I or II, were 36 ± 4% at 8 years. The predictors of good functional results after good immediate results were a younger age (p = 0.04), a lower pre-PMC New York Heart Association class (p
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(00)00761-X