Journal Article

Immediate and mid-term results of repeat percutaneous mitral commissurotomy for restenosis following earlier percutaneous mitral commissurotomy

B Iung, E Garbarz, P Michaud, O Fondard, S Helou, J Kamblock, P Berdah, P.-L Michel, P Lionet, B Cormier, G Papouin and A Vahanian

in European Heart Journal

Published on behalf of European Society of Cardiology

Volume 21, issue 20, pages 1683-1689
Published in print October 2000 | ISSN: 0195-668x
Published online October 2000 | e-ISSN: 1522-9645 | DOI: http://dx.doi.org/10.1053/euhj.1999.1992
Immediate and mid-term results of repeat percutaneous mitral commissurotomy for restenosis following earlier percutaneous mitral commissurotomy

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Aims This study assessed the results of repeat percutaneous mitral commissurotomy for mitral restenosis following a first procedure.

Methods and Results Repeat balloon commissurotomy was performed in 53 patients who had symptomatic restenosis a mean of 6±2 years (2–11) after a successful first procedure; seven patients had mildly calcified valves. All patients had restenosis with a fusion of both commissures as assessed by echocardiography. A double-balloon was used in one case and the Inoue technique in 52. Complications were stroke in one patient and severe mitral regurgitation (Sellers grade 3) in two. Valve area increased from 1·03±0·22 to 1·82±0·21cm2(P<0·0001) as assessed by planimetry. Good immediate results, defined as valve area ≥1·5cm2with no regurgitation >2/4, were obtained in 48 patients (91%). The 5-year survival rate without operation and in NYHA class I or II was 69±11% in the whole population, and 76±11% in the 48 patients who had had good immediate results.

Conclusion This study suggests that repeat balloon commissurotomy is a valid treatment for symptomatic restenosis after a first successful procedure. It gives good results in patients selected on the basis of favourable characteristics and the echocardiographic analysis of the mechanism of restenosis.

Keywords: Mitral valve, valvuloplasty, mitral restenosis

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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