PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY - EARLY AND LATE RESULTS ACCORDING TO SURGICAL RISK AND ECHOCARDIOGRAPHIC SCORE

OBJECTIVE AND DESIGN: Early results, complications and follow-up of 70 patients undergoing percutaneous balloon mitral valvuloplasty (BMV) w ere retrospectively analyzed to establish whether an increased surgica l risk or an unfavourable echocardiographic score influenced the resul ts. PATIENTS: The patients were divided into two groups according to t he presence (group A, n=31) or absence (group B, n=38) of high surgica l risk factors. The ,patients were also divided into two other groups according to the presence (group C, n=46) or absence (group D, n=20) o f favourable mitral valve anatomy. Group A (high surgical risk) includ ed patients fulfilling at least one of the following criteria: 65 year s of age or alder; previous surgical commissurotomy; depressed left ve ntricular function; respiratory or hepatic insufficiency; or previous aortic valve replacement Mitral valve anatomy was classified as 4 to 1 6, according to the echocardiographic score established by Abascal et al. Group C patients had echocardiographic score below 8 and group D h ad echocardiographic scores of 8 or greater. INTERVENTIONS: Mean mitra l valve gradient (MVG) and area (MVA) were Doppler-estimated immediate ly before and 48 h after the BMV. MAIN RESULTS: There were no differen ces in the early results and complications between groups A and B (MVA 1.8+/-0.5 versus 1.9+/-0.4 cm(2)). Final MVA was significantly greate r in group C than in group D (MVA 1.9+/-0.4 versus 1.6+/-0.4 cm(2); P= 0.03), There was no difference in the incidence of complications. Over follow-up period averaging 19.1 months (range 1 to 55), 90.7% of the patients