Predictors of Complications during Percutaneous Multitrack Balloon Mitral Valvuloplasty

Background: Percutaneous mitral balloon valvuloplasty is the main procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases; however, mitral regurgitation (MR) remains the major procedure complication. Objectives: This study was conducted to investigate predictors of MR as a complication followingpercutaneous mitral valvuloplasty (PMV) using multitrack balloon technique. Methods: This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points. Results: Most patients (N = 109, 90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR (group B) after PMV. Those who developed severe MR had significantly higher weight, height, body mass index, and body surface area (P value 35.8%, P - 13.289, P = 0.031) and MV commissural asymmetry of calcification (OR 67.48, CI 95% 5.759 - 790.72, P = 0.001) as significant predictors of outcomes of MV commissurotomy. Conclusion: Mitral valve calcification, balloon sizing, and MV asymmetry are significant factors that can predict the development of MR after balloon valvuloplasty.