Document Detail

Balloon mitral commissurotomy for patients with mitral stenosis in atrial fibrillation: ten-year clinical and echocardiographic actuarial results.
MedLine Citation:
PMID:  16359051     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM OF THE STUDY: Controversy persists as to whether atrial fibrillation (AF) has a direct negative effect on the outcome of percutaneous balloon mitral commissurotomy (PBMC). The study aim was to assess the effect of AF on immediate and 10-year clinical and echocardiographic actuarial results of patients with rheumatic mitral stenosis undergoing PBMC. METHODS: A total of 195 consecutive patients with AF (group 1) was analyzed and compared with 195 patients in sinus rhythm (group 2), matched for the severity of mitral valve morphological changes. RESULTS: Group 1 patients were older (43.8 + 12 versus 30.5 +/- 12.7 years; p <0.001), and a greater proportion had grade 1 mitral regurgitation (25.1 versus 9.7%; p <0.0001). The procedural success was 89.8% in group 1 and 92.3% in group 2 (p = NS), but group 1 patients had a smaller mitral valve area (2.1 +/- 0.4 versus 2.3 +/- 0.4 cm2; p <0.0001). Patients in AF had a lower 10-year survival (91.4 versus 99.4%; p = 0.018), a lower 10-year event-free-survival (60.3 versus 70%; p = 0.02), and a lower 10-year freedom from restenosis (40 versus 66%; p = 0.048). AF was an independent predictor of overall mortality (OR = 10.79; p <0.033) and of combined events (death, redo PBMC or mitral valve surgery; OR = 1.95; p <0.012), and was a univariate predictor of restenosis (p = 0.048). CONCLUSION: Patients with AF have good immediate results, but poorer long-term outcome after PBMC. AF a marker of worse prognosis in patients with mitral stenosis as it is in the general population.
Faouzi Maatouk; Fethi Betbout; Mohamed Ben-Farhat; Faouzi Addad; Habib Gamra; Khaldoun Ben-Hamda; Zohra Dridi; Najet Merchaoui; Sonia Hammami; Sabri Maaoui; Taoufik Hendiri; Hatem Boughanmi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  14     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-12-19     Completed Date:  2006-02-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  727-34     Citation Subset:  IM    
Cardiology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
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MeSH Terms
Atrial Fibrillation / complications*,  therapy
Balloon Dilatation*
Disease-Free Survival
Electric Countershock
Follow-Up Studies
Mitral Valve Stenosis / complications,  physiopathology,  therapy*,  ultrasonography
Rheumatic Heart Disease / complications

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