Document Detail


Percutaneous valvuloplasty for mitral valve restenosis: postballoon valvotomy patients fare better than postsurgical closed valvotomy patients.
MedLine Citation:
PMID:  20232411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To compare the results of percutaneous mitral valvuloplasty (BMV) for mitral restenosis in post-BMV versus postclosed mitral valvotomy (CMV) patients.
METHODS AND RESULTS: Ninety-two patients who underwent BMV for mitral restenosis were followed up prospectively. Of these, 28 patients had undergone previous percutaneous mitral valvuloplasty (PRIOR BMV) and 64 patients had undergone previous closed mitral valvotomy (PRIOR CMV). BMV for mitral restenosis was a success in 59% patients (57.1% PRIOR BMV, 59.3% PRIOR CMV, P = 1.0). Incidence of severe mitral regurgitation was 3.25%, all in the PRIOR CMV group. In univariate analysis, the major predictor of successful BMV for mitral restenosis was Wilkins score (P = 0.004). At a follow up of 3.47 + 2.07 years, mitral valve area was similar between groups (1.45 +/- 0.22, 1.46 +/- 0.26, P = 0.35). The combined end points of mitral valve replacement (MVR), need for re-repeat BMV for mitral restenosis or death was higher in the PRIOR CMV group (31.2% PRIOR CMV, 7.1% PRIOR BMV, P = 0.027). Event-free survival at follow up was lower in the PRIOR CMV group (69% PRIOR CMV, 92.8% PRIOR BMV) mainly due to the higher need for MVR (11 vs. 0 patients, P = 0.03).
CONCLUSIONS: In conclusion, following BMV for mitral restenosis, patients with PRIOR BMV are found to have lesser event rates on follow-up compared to patients with PRIOR CMV, though procedural success rates are similar.
Authors:
Krishnakumar Nair; Harikrishnan Sivadasanpillai; P Sivasubramonium; Padmakumar Ramachandran; Jaganmohan A Tharakan; Thomas Titus; V K Ajit Kumar; Sivasankaran Sivasubramonian; K Mahadevan Krishnamoorthy; Santosh Dora
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-11-15     Revised Date:  2011-03-30    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  174-80     Citation Subset:  IM    
Copyright Information:
(c) 2010 Wiley-Liss, Inc.
Affiliation:
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
Balloon Dilation* / adverse effects,  mortality
Cardiac Surgical Procedures* / adverse effects,  mortality
Chi-Square Distribution
Disease-Free Survival
Follow-Up Studies
Heart Valve Prosthesis Implantation
Humans
India
Kaplan-Meier Estimate
Middle Aged
Mitral Valve Stenosis / mortality,  surgery,  therapy*,  ultrasonography
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2011 Mar 1;77(4):596; author reply 597-8   [PMID:  21351237 ]

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


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