Circulation, Vol 85, 448-461, Copyright © 1992 by American Heart Association
BACKGROUND. Balloon mitral commissurotomy can increase mitral valve areas
and reduce symptoms in selected patients with mitral stenosis. The National
Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry was
organized to address concerns regarding differences in patient selection
and technique and to report the current clinical outcome. METHODS AND
RESULTS. In 24 cooperating centers, 738 patients had balloon mitral
commissurotomy. Baseline clinical, echo Doppler, and cardiac
catheterization data, procedure details, and hemodynamic and 30- day
clinical outcome were reported. Overall, 81% of the patients were women
(mean age, 54 +/- 15 years), and 24% had moderate or severe other valvular
lesions. When single- and double-balloon procedures were compared, the
final mitral valve area was larger (1.7 +/- 0.7 versus 2.0 +/- 0.8 cm2, p =
0.0009), increase in mitral regurgitation was similar (4% versus 12%, p =
0.08), and interatrial shunts occurred more frequently (2% versus 12%, p =
0.04) after double-balloon procedures. Increase in mitral valve area was
weakly related to mitral valve morphology as assessed by an echo score (r =
-0.15). Multivariate predictors of improved clinical status at 30 days were
cases performed in larger-volume centers, baseline mitral valve area
greater than 0.5 cm2, and age less than 70 years. At 30-day follow-up, 4%
of the patients with completed procedures had mitral valve surgery, 3% had
died, and 83% had their overall condition improved. Patients with mixed
mitral stenosis or regurgitation and isolated mitral stenosis had a similar
course, but fewer patients with multivalve disease became asymptomatic.
CONCLUSIONS. Balloon mitral commissurotomy, as practiced in a broad range
of experienced centers, produced significant short- term hemodynamic and
clinical improvements. Balloon mitral commissurotomy can be considered an
effective treatment option in patients with symptomatic mitral stenosis.
ARTICLES
Multicenter experience with balloon mitral commissurotomy. NHLBI Balloon Valvuloplasty Registry Report on immediate and 30-day follow-up results. The National Heart, Lung, and Blood Institute Balloon Valvuloplasty Registry Participants
This article has been cited by other articles:
 |
|
 |
|
  S. B. King III, T. Aversano, W. L. Ballard, R. H. Beekman III, M. J. Cowley, S. G. Ellis, D. P. Faxon, E. L. Hannan, J. W. Hirshfeld Jr, A. K. Jacobs, et al. ACCF/AHA/SCAI 2007 Update of the Clinical Competence Statement on Cardiac Interventional Procedures: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training (Writing Committee to Update the 1998 Clinical Competence Statement on Recommendations for the Assessment and Maintenance of Proficiency in Coronary Interventional Procedures) J. Am. Coll. Cardiol., July 3, 2007; 50(1): 82 - 108. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Fawzy, H. Hegazy, M. Shoukri, F. El Shaer, A. ElDali, and M. Al-Amri Long-term clinical and echocardiographic results after successful mitral balloon valvotomy and predictors of long-term outcome Eur. Heart J., August 2, 2005; 26(16): 1647 - 1652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Silaruks, B. Thinkhamrop, S. Kiatchoosakun, C. Wongvipaporn, and P. Tatsanavivat Resolution of Left Atrial Thrombus after 6 Months of Anticoagulation in Candidates for Percutaneous Transvenous Mitral Commissurotomy Ann Intern Med, January 20, 2004; 140(2): 101 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Langerveld, N. M. van Hemel, J. C. Kelder, J. M. P. G. Ernst, H. W. M. Plokker, and W. Jaarsma Long-term follow-up of cardiac rhythm after percutaneous mitral balloon valvotomy: Does atrial fibrillation persist? Europace, January 1, 2003; 5(1): 47 - 53. [Abstract] [PDF]
|
|
|
|
 |
|
 B D Prendergast, T R D Shaw, B Iung, A Vahanian, and D B Northridge Contemporary criteria for the selection of patients for percutaneous balloon mitral valvuloplasty Heart, May 1, 2002; 87(5): 401 - 404. [Full Text] [PDF]
|
|
|
|
|
|
S. Silaruks, B. Thinkhamrop, W. Tantikosum, C. Wongvipaporn, P. Tatsanavivat, and V. Klungboonkrong A prognostic model for predicting the disappearance of left atrial thrombi among candidates for percutaneous transvenous mitral commissurotomy J. Am. Coll. Cardiol., March 6, 2002; 39(5): 886 - 891. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Yetkin, S. Cehreli, M. ileri, K. Senen, R. Atak, A. Yanik, O. Yetkin, and H. Sasmaz Comparison of Clinical Echocardiographic and Hemodynamic Characteristics of Male and Female Patients who Underwent Mitral Balloon Valvuloplasty Angiology, December 1, 2001; 52(12): 835 - 839. [Abstract] [PDF]
|
|
|
|
|
|
B Iung, E Garbarz, P Michaud, O Fondard, S Helou, J Kamblock, P Berdah, P.-L Michel, P Lionet, B Cormier, et al. Immediate and mid-term results of repeat percutaneous mitral commissurotomy for restenosis following earlier percutaneous mitral commissurotomy Eur. Heart J., October 2, 2000; 21(20): 1683 - 1689. [Abstract] [PDF]
|
|
|
|
 |
|
 T. O. Cheng, C. R. Chen, B. Iung, E. Garbarz, P. Michaud, S. Helou, B. Farah, P. Berdah, P.-L. Michel, B. Cormier, et al. Late Results of Percutaneous Balloon Mitral Valvuloplasty: The Chinese Experience Response Circulation, July 11, 2000; 102 (2): e18 - e18. [Full Text] [PDF]
|
|
|
|
|
|
B. Iung, E. Garbarz, P. Michaud, A. Mahdhaoui, S. Helou, B. Farah, P. Berdah, P.-L. Michel, Y. Makita, B. Cormier, et al. Percutaneous mitral commissurotomy for restenosis after surgical commissurotomy: Late efficacy and implications for patient selection J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1295 - 1302. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.-H. Kang, S.-W. Park, J.-K. Song, H.-S. Kim, M.-K. Hong, J.-J. Kim, and S.-J. Park Long-term clinical and echocardiographic outcome of percutaneous mitral valvuloplasty: Randomized comparison of Inoue and double-balloon techniques J. Am. Coll. Cardiol., January 1, 2000; 35(1): 169 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Z. Pathan, N. A. Mahdi, M. N. Leon, J. Lopez-Cuellar, H. Simosa, P. C. Block, L. Harrell, and I. F. Palacios Is redo percutaneous mitral balloon valvuloplasty (PMV) indicated in patients with post-PMV mitral restenosis? J. Am. Coll. Cardiol., July 1, 1999; 34(1): 49 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Iung, E. Garbarz, P. Michaud, S. Helou, B. Farah, P. Berdah, P.-L. Michel, B. Cormier, and A. Vahanian Late Results of Percutaneous Mitral Commissurotomy in a Series of 1024 Patients : Analysis of Late Clinical Deterioration: Frequency, Anatomic Findings, and Predictive Factors Circulation, June 29, 1999; 99(25): 3272 - 3278. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Langerveld, H.W. Thijs Plokker, S.M.P.G. Ernst, J.C. Kelder, and W. Jaarsma Predictors of clinical events or restenosis during follow-up after percutaneous mitral balloon valvotomy Eur. Heart J., April 1, 1999; 20(7): 519 - 526. [Abstract] [PDF]
|
|
|
|
|
|
R. Hernandez, C. Banuelos, F. Alfonso, J. Goicolea, A. Fernandez-Ortiz, J. Escaned, L. Azcona, C. Almeria, and C. Macaya Long-Term Clinical and Echocardiographic Follow-Up After Percutaneous Mitral Valvuloplasty With the Inoue Balloon Circulation, March 30, 1999; 99(12): 1580 - 1586. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N Meneveau, F Schiele, M-F Seronde, V Breton, S Gupta, Y Bernard, and J-P Bassand Predictors of event-free survival after percutaneous mitral commissurotomy Heart, October 1, 1998; 80(4): 359 - 364. [Abstract] [Full Text]
|
|
|
|
|
|
M. B. Farhat, M. Ayari, F. Maatouk, F. Betbout, H. Gamra, M. Jarrar, M. Tiss, S. Hammami, R. Thaalbi, and F. Addad Percutaneous Balloon Versus Surgical Closed and Open Mitral Commissurotomy : Seven-Year Follow-up Results of a Randomized Trial Circulation, January 27, 1998; 97(3): 245 - 250. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Orrange, D. T. Kawanishi, B. M. Lopez, S. M. Curry, and S. H. Rahimtoola Actuarial Outcome After Catheter Balloon Commissurotomy in Patients With Mitral Stenosis Circulation, January 21, 1997; 95(2): 382 - 389. [Abstract] [Full Text]
|
|
|
|
|
|
B. Iung, B. Cormier, P. Ducimetiere, J.-M. Porte, O. Nallet, P.-L. Michel, J. Acar, and A. Vahanian Immediate Results of Percutaneous Mitral Commissurotomy: A Predictive Model on a Series of 1514 Patients Circulation, November 1, 1996; 94(9): 2124 - 2130. [Abstract] [Full Text]
|
|
|
|
 |
|
 V. P. Reyes, B. S. Raju, J. Wynne, L. W. Stephenson, R. Raju, B. S. Fromm, P. Rajagopal, P. Mehta, S. Singh, D. P. Rao, et al. Percutaneous Balloon Valvuloplasty Compared with Open Surgical Commissurotomy for Mitral Stenosis N. Engl. J. Med., October 13, 1994; 331(15): 961 - 967. [Abstract] [Full Text]
|
|