Does a baseline echocardiographic score <= 8 predict better intermediate long-term survival and freedom from combined events compared to a score > 8 in patients undergoing percutaneous mitral balloon valvotomy?
An echocardiographic score <= 8 is a strong predictor of excellent intermediate long-term survival and freedom from mitral valve replacement following percutaneous mitral balloon valvotomy.
BACKGROUND: This study is the clinical follow-up (20 +/- 12 months; range, 6 to 49 months) of 327 patients who had percutaneous mitral balloon valvotomy (PMV) at the Massachusetts General Hospital. METHODS AND RESULTS: There were seven in-hospital deaths. Patients were divided into two groups according to their echocardiographic score; 211 patients had echocardiographic scores 8. Patients with echocardiographic scores > 8 were older (64 +/- 11 versus 48 +/- 14 years, P 8. Rates of survival (98 +/- 2% versus 72 +/- 11%), survival with freedom from mitral valve replacement (91 +/- 4% versus 55 +/- 13%), and survival with freedom from combined events (79 +/- 10% versus 39 +/- 18%) at follow-up were greater in patients with echocardiographic scores < or = 8 (P < .00005). Cox regression analysis identified the echocardiographic score as the most important unfavorable intermediate long-term follow-up prediction factor after PMV. CONCLUSIONS: The excellent intermediate long-term clinical follow-up of patients with echocardiographic score < or = 8 and no calcified mitral valves suggests that PMV may be the treatment of choice in this group of patients.
Palacios et al. (Wed,) studied this question.