Balloon mitral valvotomy: immediate outcome of 300 procedures

ABSTRACT

Three hundred patients with severe symptomatic rheumatic mitral stenosis underwent balloon mitral valvotomy [BMV] at Queen Alia Heart Institute [QAHI] during the period between May 1988 to April 1994. The clinical characteristics, immediate procedural outcome, hemodynamic variables, two-dimensional echocardiography and Doppler-derived mitral valve area [MVA] were retrospectively analyzed. There were 226 females and 74 males with a mean age of 34.4 +/- 13.5 years. Sixty-four patients [21%] were in atrial fibrillation. Sixteen patients had prior surgical mitral commissurotomy, 3 patients [1%] had prior aortic valve replacement [AVR], 22 patients [7.3%] had mitral regurgitation [MR], 54 patients [18%] had associated grade II or less aortic regurgitation [AR], 1 patient [0.3%] had history of systemic embolism, and 2 patients [0.7%] were pregnant. All patients had mitral valve echo score < 10/16. A total of 286 patients [95%] had successful outcome and 270 [90%] had optimal result. In 16 patients [5%], the result was suboptimal and 14 patients [4.6%] had major complications before or after attempted balloon dilatation. One patient died of septicemia 5 days after the procedure. Minor complications occurred in 117 patients [39%], most of which did not require immediate special therapeutic measures and were well tolerated. The two most common minor complications were de novo or increased MR [21%] and tiny or small angiographic atrial septal defect [11%]. BMV is a sufficiently safe and effective procedure justifying its use as the procedure of choice in patients with severe mitral stenosis and low echo score