LONG-TERM OUTCOME OF PERCUTANEOUS MITRAL COMMISSUROTOMY

Objectives. The aim of this study was to assess the long-term results of percutaneous transvenous mitral commisurotomy in our institution, a nd to evaluate potential predictors of long-term event-free survival. Patients and methods. Between 1990 and 1996, 204 patients underwent pe rcutaneous transvenous mitral commisurotomy with an Inoue balloon. One hundred and thirty two patients were followed for up to 9 months. Mea n time of follow-up was 2,6-1,5 years (7 days-5.7 years). End points w ere considered mitral surgery, death and functional class III-IV. Long -term event-free survival analysis was performed to determine independ ent predictors of event-free survival. Results. At the end of the stud y, 88% of patients mere classified as New York Heart Association class I-II. Multivariate analysis revealed that independent predictors of m ajor events were stiffness and thickening of the valve, presence of se vere left atrial enlargement as factors pre-procedure; with suboptimal results and significant mitral regurgitation after percutaneous trans venous mitral commisurotomy. Conclusions. Percutaneous transvenous mit ral commisurotomy with Inoue balloon Is a safe and effective technique . Good results are maintained at long-term follow-up and the best resu lts are obtained in patients with flexible and thin valves, with mild or moderate enlargement of left auricle and in cases with optimal resu lts and without severe mitral regurgitation as a complication of the p rocedure.