Comparison of the immediate and long-term outcomes of Percutaneous balloon mitral valvuloplasty for severe mitral stenosis and predictors of restenosis

To study the immediate and long-term results of percutaneous balloon mitral valvuloplasty [PBMV] in patients with severe mitral stenosis and to determine the predictors of restenosis. Consecutive patients presented to King Khalid University Hospital, Riyadh, Saudi Arabia during the period from 1999 to 2003. Two hundred fifteen patients with severe symptomatic mitral stenosis submitted to PBMV using the Inoue technique. The morphological features of the mitral valve were graded using Wilkin's echocardiography score. Clinical and echocardiography data were available on follow-up on 195 patients [90.6%], 46 male and 149 females. Mean age was 32 +/- 10.9 years with a mean follow-up 96 +/- 28 months [11 month to 11 year]. Result: The procedure was successful [i.e. MVA >/= 1.5 cm[2] and mitral regurgitation [MR] < 3] in 205 patients [95%], without mortality. MVA increased from 0.98 +/- 0.27 cm[2] to 2.02 +/- 0.29 cm[2] [P<0.0001]. Acute complication occurred in 5 patients, 3 had cardiac tamponade [1.4%] and 2 had severe MR [0.9%]. There were no cases of cerebral embolism. Fifteen patients [7%] had mild worsening of MR and 19 patients [8.8%] has insignificant interatrial shunt. The restenosis rate on follow-up was 16.4%. The predictors of restenosis were the echo score and immediate mitral valve area. Our data showed that PBMV is a safe procedure with good immediate and long-term outcome.sbeta The restenosis predictors were the morphological features of the mitral valve and the area achieved at dilatation