open access

Vol 76, No 5 (2018)
Original articles
Published online: 2018-01-26
Submitted: 2017-10-02
Accepted: 2018-01-22
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Percutaneous mitral balloon valvuloplasty: beyond classic indications

Paweł Tyczyński, Zbigniew Chmielak, Witold Rużyłło, Marcin Demkow, Marek Dąbrowski, Marek Konka, Janusz Gajda, Patrycjusz Stokłosa, Adam Witkowski
DOI: 10.5603/KP.a2018.0036
·
Kardiol Pol 2018;76(5):845-851.

open access

Vol 76, No 5 (2018)
Original articles
Published online: 2018-01-26
Submitted: 2017-10-02
Accepted: 2018-01-22

Abstract

Background and aim:

In patients with mitral stenosis (MS) percutaneous mitral balloon valvuloplasty (PMBV) is used to im-prove symptoms and prognosis. Although there is some evidence for potential long-term benefits from PMBV in asymptomatic patients with mitral valve area (MVA) between 1.0 and 1.5 cm2, there are no follow-up data on patients with symptomatic MS with MVA > 1.5 cm2, who underwent PMBV.


Methods:

We retrospectively analysed periprocedural results of 113 symptomatic patients who underwent PMBV for MS with MVA > 1.5 cm2 (group 1) and compared them with a control group of patients with MVA ≤ 1.5 cm2 (group 2). Clinical and procedural variables were compared between groups.


Results:

In group 1, PMBV resulted in a significant increase of MVA as well as a decrease of mean and maximal mitral gradients and mean left atrial pressure (LAP), and a subsequent decrease of mean and systolic pulmonary artery pressures (PAPs). Moreover, 6.3% of patients developed moderate to severe (3+) or severe (4+) post-procedural mitral regurgitation (MR). Post-procedural increase in MVA and decrease of LAP were more pronounced in group 2 than group 1 (∆MVA 0.74 cm2 vs. 0.41 cm2, p < 0.05, and ∆LAP 8.2 mmHg vs. 6.0 mmHg, p < 0.05). Nonetheless, no significant differences were observed for ∆ of mean and systolic PAPs. The grade of post-procedural MR was comparable between groups.


Conclusions: PMBV is a feasible procedure in highly selected patients without classic echocardiographic indications. None-theless, it is associated with a small but non-negligible periprocedural risk of developing severe MR.

Abstract

Background and aim:

In patients with mitral stenosis (MS) percutaneous mitral balloon valvuloplasty (PMBV) is used to im-prove symptoms and prognosis. Although there is some evidence for potential long-term benefits from PMBV in asymptomatic patients with mitral valve area (MVA) between 1.0 and 1.5 cm2, there are no follow-up data on patients with symptomatic MS with MVA > 1.5 cm2, who underwent PMBV.


Methods:

We retrospectively analysed periprocedural results of 113 symptomatic patients who underwent PMBV for MS with MVA > 1.5 cm2 (group 1) and compared them with a control group of patients with MVA ≤ 1.5 cm2 (group 2). Clinical and procedural variables were compared between groups.


Results:

In group 1, PMBV resulted in a significant increase of MVA as well as a decrease of mean and maximal mitral gradients and mean left atrial pressure (LAP), and a subsequent decrease of mean and systolic pulmonary artery pressures (PAPs). Moreover, 6.3% of patients developed moderate to severe (3+) or severe (4+) post-procedural mitral regurgitation (MR). Post-procedural increase in MVA and decrease of LAP were more pronounced in group 2 than group 1 (∆MVA 0.74 cm2 vs. 0.41 cm2, p < 0.05, and ∆LAP 8.2 mmHg vs. 6.0 mmHg, p < 0.05). Nonetheless, no significant differences were observed for ∆ of mean and systolic PAPs. The grade of post-procedural MR was comparable between groups.


Conclusions: PMBV is a feasible procedure in highly selected patients without classic echocardiographic indications. None-theless, it is associated with a small but non-negligible periprocedural risk of developing severe MR.

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Keywords

mitral stenosis, percutaneous mitral balloon valvuloplasty

About this article
Title

Percutaneous mitral balloon valvuloplasty: beyond classic indications

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 5 (2018)

Pages

845-851

Published online

2018-01-26

DOI

10.5603/KP.a2018.0036

Bibliographic record

Kardiol Pol 2018;76(5):845-851.

Keywords

mitral stenosis
percutaneous mitral balloon valvuloplasty

Authors

Paweł Tyczyński
Zbigniew Chmielak
Witold Rużyłło
Marcin Demkow
Marek Dąbrowski
Marek Konka
Janusz Gajda
Patrycjusz Stokłosa
Adam Witkowski

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