TY - JOUR
T1 - Restenosis and adverse clinical events after successful percutaneous mitral valvuloplasty
T2 - Immediate post-procedural mitral valve area as an important prognosticator
AU - Song, Jae Kwan
AU - Song, Jong Min
AU - Kang, Duk Hyun
AU - Yun, Sung Cheol
AU - Park, Duk Woo
AU - Lee, Seung Whan
AU - Kim, Young Hak
AU - Lee, Cheol Whan
AU - Hong, Myeong Ki
AU - Kim, Jae Joong
AU - Park, Seong Wook
AU - Park, Seung Jung
PY - 2009/5
Y1 - 2009/5
N2 - Aims: We sought to investigate the factors associated with restenosis and its potential association with late clinical deterioration after successful percutaneous mitral valvuloplasty (PMV).Methods and resultsWe analysed echocardiographic (median 74 months) and clinical (median 109 months) follow-up data of 329 patients who achieved procedural success, defined as mitral valve area (MVA) ≥1.5 cm2 and mitral regurgitation (MR) ≤2/4, between 1995 and 2000. Clinical events included cardiovascular death, mitral valve surgery, and repeat PMV. The 1, 3, 5, 7, and 9 year rates of restenosis-free survival were 99 ± 1, 97 ± 1, 95 ± 1, 86 ± 3, and 72 ± 4, respectively. The 1, 3, 5, 7, and 9 year rates of event-free survival were 99.7 ± 0.3, 96.4 ± 1.0, 94.5 ± 1.3, 90.8 ± 1.6, and 90.0 ± 1.7, respectively. Immediate post-PMV MVA and commissural MR or splitting, indicators of procedural adequacy, were independent predictors of both restenosis and clinical events. The best immediate post-PMV MVA cut-off value for predicting both restenosis and clinical events within 5 years after successful PMV were 1.8 cm2 [95 confidence interval (CI) = 1.7-1.9] and 1.9 cm2 (95 CI = 1.7-2.0), respectively. Patients with immediate post-PMV MVA <1.8 cm2 showed significantly lower event-free survival rate than those with post-PMV MVA ≥1.8 cm2 (P < 0.001).ConclusionImmediate post-PMV MVA≥1.8 cm2 was an important predictor of both restenosis- and clinical event-free survival and this value should be considered as a component of optimal result.
AB - Aims: We sought to investigate the factors associated with restenosis and its potential association with late clinical deterioration after successful percutaneous mitral valvuloplasty (PMV).Methods and resultsWe analysed echocardiographic (median 74 months) and clinical (median 109 months) follow-up data of 329 patients who achieved procedural success, defined as mitral valve area (MVA) ≥1.5 cm2 and mitral regurgitation (MR) ≤2/4, between 1995 and 2000. Clinical events included cardiovascular death, mitral valve surgery, and repeat PMV. The 1, 3, 5, 7, and 9 year rates of restenosis-free survival were 99 ± 1, 97 ± 1, 95 ± 1, 86 ± 3, and 72 ± 4, respectively. The 1, 3, 5, 7, and 9 year rates of event-free survival were 99.7 ± 0.3, 96.4 ± 1.0, 94.5 ± 1.3, 90.8 ± 1.6, and 90.0 ± 1.7, respectively. Immediate post-PMV MVA and commissural MR or splitting, indicators of procedural adequacy, were independent predictors of both restenosis and clinical events. The best immediate post-PMV MVA cut-off value for predicting both restenosis and clinical events within 5 years after successful PMV were 1.8 cm2 [95 confidence interval (CI) = 1.7-1.9] and 1.9 cm2 (95 CI = 1.7-2.0), respectively. Patients with immediate post-PMV MVA <1.8 cm2 showed significantly lower event-free survival rate than those with post-PMV MVA ≥1.8 cm2 (P < 0.001).ConclusionImmediate post-PMV MVA≥1.8 cm2 was an important predictor of both restenosis- and clinical event-free survival and this value should be considered as a component of optimal result.
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U2 - 10.1093/eurheartj/ehp096
DO - 10.1093/eurheartj/ehp096
M3 - Article
C2 - 19346230
AN - SCOPUS:66249139583
SN - 0195-668X
VL - 30
SP - 1254
EP - 1262
JO - European Heart Journal
JF - European Heart Journal
IS - 10
ER -