Author + information
- Alfredo Ferreira Neto,
- Jose de Ribamar Costa,
- Auristela Ramos,
- Rafael Meneguz-Moreno,
- Sergio Braga,
- Dimytri Siqueira,
- Zilda Meneghelo,
- Nisia Gomes,
- Cesar Esteves,
- Mercedes Maldonado,
- Amanda Sousa and
- Alexandre Abizaid
Background: Percutaneous Mitral Balloon Valvuloplasty (PMBV), has been the preferred treatment for mitral valve stenosis, particularly when secondary to rheumatic heart disease. However, its recurrence is found to happen, due to unclear factors, in a significant number of patients submitted to this procedure.
Methods: This study reports the vast experience of a single center high volume tertiary institution where 1,794 consecutive patients were treated with PMBV between 1987 and 2011. The primary endpoint was to better determine the patients who present good outcomes from the procedure, by pointing out the independent pre-procedural echocardiographic predictors of mitral valve restenosis.
Results: Mitral valve restenosis was observed in 26% of the cases (n=483). Average population age was 36 years old, with most patients being female (87%). Mean follow up duration was 4.8 years. At multivariate analysis independent pre-procedural predictors of restenosis were: left atrial diameter (HR: 1.03, 95% CI: 1.01-1.04, p<0.01), pre procedure maximum gradient (HR: 1.01, 95% CI: 1.00-1.03, p=0.02) and higher Wilkins scores (HR: 1.37, 95% CI: 1.13-1.66, p<0.01).
Conclusions: In the very long term follow-up, mitral valve restenosis was observed in a quarter of the population undergoing PMBV. Preprocedure echocardiographic findings, including left atrial diameter, maximum valve gradient and high Wilkins scores were found to be the only independent predictors of this deleterious event.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Structural Heart Interventions: Focus on Mitral Valve, Left Atrial Appendage and HOCM
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1156-178
- 2017 American College of Cardiology Foundation