The Long-term Follow-up Results after Successful Double-Balloon Percutaneous Mitral Commissurotomy

Background and Objectives:This study was performed to assess long-term clinical outcome and restenosis rate after percutaneous mitral commissurotomy (PMC) and to identify the predictable factors influencing the clinical outcome and restenosis. Method:Patients underwent PMC at Seoul National University Hospital between August, 1988 and January, 1999 (total 394 cases, mean follow-up duration:75±32 months) were enrolled. Successful PMC is defined as post-PMC mitral valve area (MVA) ≥1.5 cm or ≥25% increase and MR ≤moderate. Restenosis is defined as MVA 50% reduction of initial gain. Major clinical events include repeated PMC, mitral valve replacement, stroke, and death. Results:After PMC mitral valve area increased from 1.01±0.33 cm to 2.23±0.89 cm. The 9-year event-free survival rate is 78%. The independent predictors of event-free survival rate are echocardiographic score (p=0.0068) and post-PMC pulmonary artery systolic pressure (p=0.0255). The 9-year restenosis-free survival rate is 44%. The independent predictors of restenosis-free survival are age (p=0.0000), echocardiographic score (p=0.0052) and post-PMC left atrial volume (p=0.0445). For 10-year follow-up, average MVA loss is 0.24 cm:0.17 cm in patent group and 0.34 cm2 in restenosis group. Conclusion:Percutaneous mitral commissurotomy as a treatment for patients with mitral stenosis is safe and achieves good long-term results. (Korean Circulation J 2000;30(11):1395-1403)