Inoue balloon mitral valvuloplasty: long-term clinical and echocardiographic follow-up of a predominantly unfavourable population

Aims To assess long-term outcome in a typical Western population of predominantly unfavourable patients undergoing Inoue balloon mitral valvuloplasty. Outcome amongst patients has only been undertaken in the medium term. Long-term echocardiographic data in particular are scarce. Methods Inoue mitral...

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Bibliographic Details
Published in:European heart journal 2000-10, Vol.21 (20), p.1690-1697
Main Authors: Hildick-Smith, D.J.R, Taylor, G.J, Shapiro, L.M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Catheterization - adverse effects
Diseases of the cardiovascular system
Echocardiography
Female
Follow-Up Studies
Humans
inoui balloon
long-term follow up
Male
Medical sciences
Middle Aged
Mitral Valve Stenosis - diagnostic imaging
Mitral Valve Stenosis - therapy
Mitral valvuloplasty
outcome measures
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Retrospective Studies
Survival Analysis
Treatment Outcome
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Summary:Aims To assess long-term outcome in a typical Western population of predominantly unfavourable patients undergoing Inoue balloon mitral valvuloplasty. Outcome amongst patients has only been undertaken in the medium term. Long-term echocardiographic data in particular are scarce. Methods Inoue mitral valvuloplasty was attempted in 106 patients. There were six technical failures; the procedure was therefore completed in 100 patients, who underwent annual clinical and echocardiographic follow-up. Results Patients were aged 63·5±10·3 years. 82% were female. Unfavourable characteristics included age >65 (52%), NYHA class III or IV (87%), ≥1 significant co-morbidity (63%), atrial fibrillation (82%), previous surgical commissurotomy (25%) and echocardiographic score >8 (59%, mean 8·9±2·1). Mitral valve area increased from 0·98±0·23 to 1·54±0·31cm2. There were three major complications. Post-procedure, symptoms improved in 88% of patients. Haemodynamic success (mitral valve area increase >50%, final mitral valve area >1·5cm2, mitral regurgitation ≤grade 2) was achieved in 61% of cases. Mean follow-up was 4·3±1·4 years. Survival was 97%, 88% and 82% at 1, 3 and 6 years. Event-free survival (freedom from death, mitral valve replacement or repeat valvuloplasty) was 96%, 82% and 56% at 1, 3 and 6 years. Freedom from restenosis (loss of >50% gain in mitral valve area, mitral valve area
ISSN:0195-668X
1522-9645
DOI:10.1053/euhj.2000.2241