Abstract 20155: 15-year Outcomes and Predictors of Success for Percutaneous Mitral Commissurotomy for Rheumatic Mitral Stenosis
Background: Rheumatic heart disease remains the most common acquired heart disease in children, especially in developing countries. This study aims to investigate the predictors of immediate procedural success and the immediate and long-term outcomes in patients undergoing percutaneous mitral commissurotomy (PTMC).
Methods: A total of 1552 patients with rheumatic mitral stenosis and underwent PTMC from 1989 to 2012 were identified. We divided the group according to Wilkins score as low risk (≤5), intermediate risk (6-8) and high-risk (≥9). Procedural success was defined as mitral valve area greater than 1.0cm2 with a mean gradient of less than 10mmHg.
Results: The median age was 36 years old [IQR 28-45]. The majority of patients was female (78.5%) and did not have any other valve involvements (85.0%). Most of cases were elective (99.5%) although 103 patients were pregnant (6.6%) during PTMC. The mitral valve area increased from 0.8cm2 [IQR 0.7-1.0] pre-procedure to 1.5cm2 [IQR 1.3-1.7] post-procedure, with a reduction in the mean pressure gradient of 15mmHg [IQR 12-20] to 4mmhg [IQR 2-6] post-procedure (all p< 0.05). Using logistic regression analysis, no difference was seen in immediate procedural success between increasing age, previous PTMC, emergency cases, New York Heart Association status, balloon size or increasing risk groups (all p>0.05). During the 15-year follow-up, the majority of patients were still alive.
Conclusions: PTMC appears to be safe and effective in our population, irrespective of older age, higher NYHA class, higher Wilkins score and previous PTMC with good immediate and long-term outcomes.
Author Disclosures: A. Omar: None. A. Ariff: None. R. Zambahari: None. R. Mohd Ali: None.
- © 2014 by American Heart Association, Inc.