부산대학교 도서관

Objectives: To assess the long-term results (up to 16.5 years) of mitral balloon valvuloplasty (MBV) and to identify predictors of restenosis and event-free survival. Methods and Results: We report the immediate and long-term clinical and echocardiographic results in 518 patients, mean age 31 ± 11 years, who underwent successful MBV for severe mitral stenosis (MS) and were followed up for 0.5–16.5 (mean 6 ± 4.5) years. After MBV, mitral valve area (MVA) increased from 0.84 ± 0.2 to 1.83 ± 0.53 cm2 (P < 0.0001) as measured by catheter and from 0.92 ± 0.17 to 1.96 ± 0.29 cm2 (P < 0.0001) as measured by two-dimensional echo. Restenosis occurred in 111 patients (21%) and it was less frequent in patients with low echo score (11%). Actuarial freedom from restenosis at 5, 10, 15 years was 85 ± 1%, 70 ± 3%, and 44 ± 5%, respectively, and was significantly higher in patients with low echo score. Event-free survival (death, redo MBV, mitral valve replacement, New York Heart Association [NYHA] functional class III or IV) at 5, 10, 15 years was 89 ± 1%, 79 ± 2%, 43 ± 9%, respectively, and was significantly higher for patients with low echo score. Cox regression analysis identified mitral echocardiographic score (MES) > 8 (P < 0.0001), postprocedure mitral valve area (MVA) (P = 0.0015), and preprocedure functional class (P = 0.014) as predictors of restenosis and MES (P < 0.0001) and age (P < 0.0001) and postprocedure MVA (P = 0.015) as predictors of event-free survival. Conclusions: MBV provides excellent long-term results for selected patients with MS. The long-term outcome after this procedure can be predicted from baseline clinical and echocardiographic characteristics. [ABSTRACT FROM AUTHOR]