Percutaneous mitral balloon valvuloplasty significantly reduced systolic pulmonary artery pressure from 89.9 mm Hg to 54.5 mm Hg in patients with mitral stenosis and severe pulmonary hypertension.
Observational (n=85)
No
Does percutaneous mitral balloon valvuloplasty improve hemodynamics and valve area in patients with rheumatic mitral stenosis and severe pulmonary hypertension?
Percutaneous mitral balloon valvuloplasty provides significant and sustained hemodynamic improvements in patients with rheumatic mitral stenosis complicated by severe pulmonary hypertension.
Absolute Event Rate: 54.5% vs 89.9%
p-value: p=<0.001
BACKGROUND: The primary goal of this study is to evaluate the immediate and long-term ef-fects of percutaneous mitral balloon valvuloplasty (PBMV) on patients with rheumatic mitral stenosis (MS) complicated with severe pulmonary hypertension (PH). METHODS: The study population consisted of 85 patients with MS complicated with severe PH (systolic pulmonary pressure > 75 mm Hg). PBMV was performed with Inoue balloon technique. Clinical and echocardiographic follow-up was scheduled at 6 months and 1 year and yearly thereafter. RESULTS: Mitral valve area (MVA) was increased (pre-PBMV MVA was 1.03 ± 0.21 cm2, post-PBMV MVA 1.89 ± 0.34 cm2, p < 0.001) significantly. The mean and the maximum transmitral pressure gradient significantly decreased (pre-PBMV mean transmitral gradient was 18.47 ± 6.59 mm Hg, post-PBMV 6.84 ± 3.84 mm Hg, p < 0.001, pre-PBMV maximum transmitral pressure gradient was 27.6 ± 8.38 mm Hg, post-PBMV 12.68 ± 4.74 mm Hg, p < 0.001). Systolic pulmonary artery pressure (SPAP) significantly decreased (pre-PBMV 89.9 ± 23.38 mm Hg, post-PBMV 54.5 ± 14.6 mm Hg, p < 0.001). Two patients underwent surgery due to rupture of anterior mitral leaflet. There was no peri-procedural mortality. The procedure time was 29.12 ± 11.37 min. Follow-up duration was 108.2 ± 31.4 months. One patient died due to heart failure. One patient underwent re-PBMV and 7 patients mitral valve replacement. At the last follow-up, MVA still remained high (1.52 ± 0.34 cm2) and mean transmitral pressure gradient was low (9.2 ± 5.7 mm Hg). SPAP was 56.5 ± 20.8 mm Hg which was the same as after PBMV. CONCLUSIONS: PBMV in patients with MS with severe PH is an effective therapy with low procedure time. However, it is recommended to perform PBMV before developing severe PH.
Özkan et al. (Mon,) conducted a observational in Rheumatic mitral stenosis complicated with severe pulmonary hypertension (n=85). Percutaneous mitral balloon valvuloplasty (PBMV) vs. Pre-procedure baseline was evaluated on Systolic pulmonary artery pressure (SPAP) (p=<0.001). Percutaneous mitral balloon valvuloplasty significantly reduced systolic pulmonary artery pressure from 89.9 mm Hg to 54.5 mm Hg in patients with mitral stenosis and severe pulmonary hypertension.