Repeat percutaneous mitral valvuloplasty [PMV] in patients with restenosis following to previous PMV

ABSTRACT

Symptomatic mitral restenosis developed in 4% to 39% of patients after PMV. It is unknown that these patients may benefit from repeat percutaneous mitral valvuloplasty [PMV]. This study assesses the immediate and early outcomes of redo PMV in patients with restenosis after prior PMV. Our study report the immediate and early outcome of 54 patients [mean age 38 +/- K2 years, 14 women and 40 male] with symptomatic mitral restenosis after prior PMV, who were treated with a repeat PMV at 3.8+2.4 years after the initial PMV. After the procedure there was a substantial increase in mitral valve area [MVA] from 1.0 + 0.2 to2.2 +/- 0.4 cm [p<0.001] and a decrease in left atrial pressure from 27+8 to 15 +/- 6mm Hg [p<0.001] and in mitral valve gradient from 17+4 to 2+1 mm Hg [P <0.001]. Mean pulmonary artery pressure did not change significantly with redo-PMV. No patient developed severe mitral regurgitation [3+] after redo PMV. Successful procedural outcome [post-PMV mitral valve area>=l .5 cm[2], pulmonary /systemic flow ratio=mitral regurgitation with a post- PMV mitral regurgitation<+3] was achieved in 50 [92.5%] of patients. In conclusion repeat percutaneous mitral valvuloplasty in patients with restenosis following to a previous percutaneous valvuloplasty can be accomplished with acceptable results. It gives in patients selected on the basis of favourable characteristics and the echocardiographic analysis of the restenotic mitral valve