Short-term follow-up results of percutaneous mitral balloon valvuloplasty: A single-center experience

Year 2014, , 695 - 699, 01.12.2014

Abdulkadir Yıldız Hasan Kaya Faruk Ertaş Nihat Polat Mesut Aydin Murat Yuksel Serdar Soydinc Murat Çaylı Mehmet Sıddık Ulgen Nizamettin Toprak

https://doi.org/10.5798/diclemedj.0921.2014.04.0502

Cited By: 2

Abstract

Objective: We sought to analyze short-term clinical, echocardiographic, and hemodynamic consequences of percutaneous mitral balloon valvuloplasty (PMBV) in the treatment of rheumatic mitral stenosis (MS) in our clinic. Methods: We retrospectively reviewed 53 patients (49 females, 5 males; mean age 38±11 years) who underwent PMBV for moderate or severe MS between January 2010 and October 2014. Procedural success was defined as the reaching a mitral valve area (MVA) >1.5 cm2 and absence of grade 3 mitral regurgitation. Results: We were able to perform PMBV in 48 of 53 patients (91%) and all the procedures that were completed were successful. PMBV couldn\'t be performed in 3 patients due to inability to pass the mitral valve, 1 patient due to membranous obstructive vena cava and 1 patient due inability to perform septostomi. Two patients who underwent successful PMBV became symptomatic after an average of 14 months follow-up and mitral valve replacement was performed due to moderate-to-severe MS. Patients were followed for an average of 13 ± 8 months and atrial fibrillation development or embolic complications were not observed. Conclusion: Percutaneous mitral balloon valvuloplasty procedure is a safe and effective treatment approach with high success and low complication rates in experienced centers.

Keywords

Mitral stenosis, percutaneous mitral balloon valvuloplasty, echocardiography, mitral valve area

Perkütan mitral balon valvüloplasti kısa dönem takip sonuçları: Tek merkez deneyimi

Abstract

Amaç: Bu çalışmada kliniğimizdeki romatizmal mitral darlıklı (MD) erişkin hastalara uygulanan perkütan mitral balon valvüloplastinin (PMBV) erken dönem klinik, ekokardiyografik ve hemodinamik sonuçlarını değerlendirmeyi amaçladık. Yöntemler: Kliniğimizde Ocak 2010-Ekim 2014 tarihleri arasında orta ya da ciddi MD nedeniyle PMBV uygulanan 53 hasta (49 kadın, 5 erkek; ortalama yaş 38±11 yıl) geriye dönük olarak değerlendirildi. İşlem başarısı, işlem sonrası mitral kapak alanının (MKA) >1,5 cm2 olması ve 3. derece mitral yetersizlik (MY) olmaması olarak kabul edildi. Bulgular: Toplam 53 hastadan 48\'inde (%91) PMBV işlemi uygulanabildi ve tamamlanabilen tüm işlemler başarılı oldu. Hastalardan 3\'üne kapak geçilememesi, 1\'ine membranöz obstrüktif vena kava, 1\'ine de septostomi yapılamaması nedeniyle PMBV uygulanamadı. Başarılı PMBV uygulanan 2 hastaya ortalama 14 ay sonra semptomatik orta-ciddi MD nedeniyle mitral kapak replasmanı yapıldı. Ortalama 13±8 ay boyunca izlenen hastalarda atrial fibrilasyon gelişmesi veya embolik komplikasyonlar izlenmedi. Sonuç: Perkütan mitral balon valvüloplasti işlemi deneyimli merkezlerde yüksek başarı ve düşük komplikasyon oranları ile etkin ve güvenli bir tedavi yaklaşımıdır.

Keywords

Mitral darlık, perkütan mitral balon valvüloplasti, ekokardiyografi, mitral kapak alanı

References

• Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardi- ology/American Heart Association Task Force on Practice Guidelines. J Thoracic Cardiovasc Surg 2014;148:e1-e132.
• Mrozowska E, Krzeminska-Pakula M, Rogowski W, et al. [Atrial fibrillation in mitral valve disease--risk factors]. Polskie Archiwum Medycyny Wewnetrznej 1999;101:45- 53.
• Acarturk E, Usal A, Demir M, et al. Thromboembolism risk in patients with mitral stenosis. Japan Heart J 1997;38:669- 675.
• Walston A, Peter RH, Morris JJ, et al. Clinical implications of pulmonary hypertension in mitral stenosis. Am J Cardiol 1973;32:650-655.
• Inoue K, Owaki T, Nakamura T, et al. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. The Journal of thoracic and cardiovascular surgery 1984;87:394-402.
• Multicenter experience with balloon mitral commissuroto- my. NHLBI Balloon Valvuloplasty Registry Report on im- mediate and 30-day follow-up results. The National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry Participants. Circulation 1992;85:448-461.
• Korkmaz S, Aksu T, Sasmaz H, et al. [Acute results of percu- taneous mitral balloon valvuloplasty]. Turk Kardiyol Dern Ars 2011;39:137-142.
• Chen CR, Cheng TO. Percutaneous balloon mitral valvulo- plasty by the Inoue technique: a multicenter study of 4832 patients in China. Am Heart J 1995;129:1197-203.
• Cohen DJ, Kuntz RE, Gordon SP, et al. Predictors of long- term outcome after percutaneous balloon mitral valvulo- plasty. N Engl J Med 1992;327:1329-1335.
• Dean LS, Mickel M, Bonan R, et al. Four-year follow-up of patients undergoing percutaneous balloon mitral com- missurotomy. A report from the National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry. J Am Coll Cardiol 1996;28:1452-1457.
• Fawzy ME, Hegazy H, Shoukri M, et al. Long-term clinical and echocardiographic results after successful mitral bal- loon valvotomy and predictors of long-term outcome. Eur Heart J 2005;26:1647-1652.
• Baumgartner H, Hung J, Bermejo J, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr 2009;22:1-23.
• Wilkins GT, Weyman AE, Abascal VM, et al. Percutaneous balloon dilatation of the mitral valve: an analysis of echo- cardiographic variables related to outcome and the mecha- nism of dilatation. Br Heart J 1988;60:299-308.
• Song JK, Song JM, Kang DH, et al. Restenosis and adverse clinical events after successful percutaneous mitral valvu- loplasty: immediate post-procedural mitral valve area as an important prognosticator. Eur Heart J 2009;30:1254-1262.
• Gurkaynak F, Ozer C, Cehreli S, et al. Perkutan balon mit- ral valvuloplastinin erken ve kısa dönemlerdeki etkinliği- nin noninvaziv olarak değerlendirilmesi. Türkiye Klinikleri Kardiyoloji 1990;3:240-246.
• San M, Bozkurt A, Usal A, ve ark. Perkutan mitral balon valvüloplasti olgularımızın erken dönem sonuçları. Gazian- tep Universitesi Tip Fakultesi Dergisi 1998;9:33-37.
• Guray Y, Guray U, Demirkan B, et al. Effect of percuta- neous mitral balloon valvuloplasty in various age groups. Turkiye Klinikleri J Cardiovasc Sci 2006;18:103-106.