The Long-term Follow-up Results after Successful Double-Balloon Percutaneous Mitral Commissurotomy

ABSTRACT

BACKGROUND AND OBJECTIVES: This study was performed to assess long-term clinical outcome and restenosis rate after percutaneous mitral commissurotomy(PMC) and to identify the predictable factors influencing the clinical outcome and restenosis. METHOD: Patients underwent PMC at Seoul National University Hospital between August, 1988 and January, 1999(total 394 cases, mean follow-up duration 75+/-32months) were enrolled. Successful PMC is defined as post-PMC mitral valve area(MVA) > or =1.5cm2 or > or =25% increase and MR 50% reduction of initial gain. Major clinical events include repeated PMC, mitral valve replacement, stroke, and death. RESULTS: After PMC mitral valve area increased from 1.01+/-0.33cm2 to 2.23+/-0.89cm2. The 9-year event-free survival rate is 78%. The independent predictors of event-free survival rate are echocardiographic score(p=.0068) and post-PMC pulmonary artery systolic pressure(p=.0255). The 9-year restenosis-free survival rate is 44%. The independent predictors of restenosis-free survival are age(p=.0000), echocardiographic score(p=.0052) and post-PMC left atrial volume(p=.0445). For 10-year follow-up, average MVA loss is 0.24cm2 0.17cm2 in patent group and 0.34cm2 in restenosis group. CONCLUSION: Percutaneous mitral commissurotomy as a treatment for patients with mitral stenosis is safe and achieves good long-term results.