Author + information
- Rafael A. Meneguz-Moreno,
- Jose de Ribamar Costa,
- Auristela Ramos,
- Nisia Gomes,
- Zilda Meneghelo,
- Alfredo Ferreira Neto,
- Dimytri Siqueira,
- Sergio Braga,
- Cesar Esteves,
- Amanda Sousa and
- Alexandre Abizaid
Background: Percutaneous balloon mitral valvuloplasty (PMV) is an attractive therapeutic approach in patients with mitral stenosis. The aim of this study was to assess the immediate and long-term clinical, echocardiographic and haemodynamic outcomes of PMV in patients with severe pulmonary hypertension (PAH).
Methods: Among all procedures (in more than two decades of experience), PMV was performed from 1987 until 2011 at a single-center in 147 patients who had significant PAH defined as baseline pulmonary artery mean pressure (PAMP) (systolic pulmonary pressure > 75 mmHg). All-cause mortality, need for mitral valve replacement (MVR) or new PMV, and valve restenosis were evaluated during follow-up yearly.
Results: Mean age was 33.8 ± 12.8 years and 83.6% (123 patients) were women. Primary success was achieved in 89.8% of the patients (132 patients). Mitral valve area increased from 0.83 ± 0.17 cm2 to 2.03± 0.35 cm2 (p<0.001), and at 20-years, mitral valve area was 1.46 ± 0.34 cm2 (p=0.235). Systolic pulmonary artery pressure decreased from 87.0 ± 6.0 mmHg to 60.0 ± 0.9 mmHg (p<0.0001). The rates of all-cause mortality, need for MVR, new PMV, and valve restenosis were 0.67%, 20.0%, 8.78% and 30.4%, respectively, in long-term follow-up (mean 15.6 ± 4.9 years).
Conclusions: Percutaneous balloon mitral valvuloplasty is a safe and effective technique for the treatment of patients with mitral stenosis and PAH. A significant decrease in pulmonary pressure was observed after valvuloplasty. Although there was a gradual decrease of MVA at long-term follow-up, most patients remained asymptomatic and without major adverse events.
Poster Contributions Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: Structural Heart Disease
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1241-141
- 2017 American College of Cardiology Foundation