Valvuloplastía mitral percutánea como tratamiento de elección de la estenosis mitral: resultados inmediatos y seguimiento alejado / Balloom mitral valvuloplasty as a treatment of choice for mitral stenosis: immediate and long term results

RESUMO

We evaluated 77 patients with sympytomatic mitral stenosis for balloon valvuloplasty. Five patients were excluded from the procedure due to the presence of intra-atrial thrombi or mitral valve endocarditis as detected by 20 echocardiography. The mean age of the 72 treated patiens was 38 ñ 11 years, 68 were NYHA functional class II or IV only 6 patients had valvular calcification. Three patients had severe liver failure, 2 were chronic alcoholics, one had liver cirrhosis, 2 had sever weight loss and 13 pulmonary hypertension at systemic levels. 69 patients had a technically adequate procedure, one patient died, 1 developed cardiac tamponade and 1 failed. Mitral valve area increased from 0.93 ñ 0.34 to 2.38 ñ 0.67 cm2. Mitral incompetence increased in only 16 patients. After a mean follow up period of 15 ñ 5 months (range 8 to 27, 56 patients remained in FC I or II. Mitral valve area remained satisfactory in 54 patients. Mitral valve anatomy evaluated by echocardiography is helpful to predict immediate and late outcome. We conclude that balloon mitral valvuloplasty is the first choice for patients with severe symptomatic mitral stenosis