Document Detail


Long-term (up to 18 years) clinical and echocardiographic results of mitral balloon valvuloplasty in children in comparison with adult population.
MedLine Citation:
PMID:  18422518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The purpose of this study was to assess the safety, efficacy, and long-term results (up to 18 years) of mitral balloon valvuloplasty (MBV) in children in comparison to adults. METHODS: 57 children age < or = 18 years (group A) and 474 adult patients (group B) who underwent successful MBV and were followed up for a mean 8.5 +/- 4.8 (range 1.5-18) years were analyzed. RESULTS: Patients in group A had a lower mitral echocardiographic score (echo score), 7.6 +/- 1.3 vs. 8.1 +/- 1 (P = 0.0005); smaller Doppler mitral valve area (MVA), 0.82 +/- 0.16 cm(2) vs. 0.92 +/- 0.17 cm(2) (P < 0.0001); and higher mitral valve gradient, 15.2 +/- 2.3 mmHg vs. 14.3 +/- 2.1 mmHg (P = 0.0003), than group B. Immediately after MBV, group A had larger MVA whether measured by catheter, 1.99 +/- 0.57 cm(2) vs. 1.8 +/- 0.52 cm(2) (P < 0.001), or by Doppler, 2.0 +/- 0.27 cm(2) vs. 1.97 +/- 0.28 cm(2) (P < 0.01), and similar complication rates, compared to group B. After a mean follow-up of 8.5 +/- 4.8 (range 1.5-18 years), restenosis in group A was 26% vs. 31% for group B (P = 0.41). Echo score > 8 (P = 0.046) was a predictor of restenosis in children and echo score > 8 (P < 0.0001) and previous surgery (P = 0.043) were predictors of restenosis in adults. Actuarial freedom from restenosis at 10, 15, and 18 years for groups A and B were 78%+/- 7%, 64%+/- 9%, and 18%+/- 14% and 77%+/- 2%, 43%+/- 4%, and 17%+/- 4%, respectively (P = 0.26). Event-free survival rates at 10, 15, and 18 years were 87%+/- 6%, 62%+/- 1%, and 20%+/- 2% versus 87%+/- 1%, 51%+/- 4%, and 20%+/- 5% for groups A and B, respectively (P = 0.51). Postprocedure MVA < 2.0 cm(2) (P = 0.043) and previous surgery (P = 0.03) were identified as predictors of events in children. Echo score > 8 (P < 0.0001) and prevalvuloplasty AF (P = 0.03) were identified as predictors of events in adults. CONCLUSION: MBV is safe and effective in children with rheumatic MS. It provides better immediate results than in adults and excellent long-term results that are comparable to those seen in adults.
Authors:
Mohamed Eid Fawzy; Miltiadis Stefadouros; Souad El Amraoui; Adil Osman; Iman Ibrahim; Omar Nowayhed; Abdelmoneim Eldali; Charles Canver
Related Documents :
20338328 - Midterm results of valve repair with a biodegradable annuloplasty ring for acute endoca...
12352348 - Urethral mobilization and advancement for midshaft to distal hypospadias.
20598968 - The everest ii trial: design and rationale for a randomized study of the evalve mitracl...
2135678 - Long-term prognosis of acute rheumatic carditis with combined aortic and mitral regurgi...
23613988 - A prospective study on the incidence of postoperative venous thromboembolism in korean ...
7046318 - Comparison of rubber band ligation and sclerosant injection for first and second degree...
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-17
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  21     ISSN:  0896-4327     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-08-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  252-9     Citation Subset:  IM    
Affiliation:
King Faisal Heart Institute, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. fawzy100@hotmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Balloon Dilatation*
Disease-Free Survival
Echocardiography
Female
Follow-Up Studies
Humans
Male
Mitral Valve Stenosis / diagnosis,  prevention & control,  therapy*,  ultrasonography*
Recurrence
Severity of Illness Index
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Vascular endothelial growth factor-165 gene therapy promotes cardiomyogenesis in reperfused myocardi...
Next Document:  Diazepam versus fentanyl for premedication during percutaneous coronary intervention: results from t...