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Left atrial size predicts long-term outcome after balloon mitral valvuloplasty.

Authors :
Canetti M
Kuperstein R
Cohen I
Raibman-Spector S
Maor E
Hai I
Barbash IM
Regev E
Butnaru A
Segev A
Guetta V
Fefer P
Source :
Cardiology journal [Cardiol J] 2023; Vol. 30 (5), pp. 753-761. Date of Electronic Publication: 2022 Oct 06.
Publication Year :
2023

Abstract

Background: The treatment of choice for severe rheumatic mitral stenosis is balloon mitral valvuloplasty (BMV). Numerous predictors of immediate and long-term procedural success have been described. The aims of this study were to describe our experience with BMV over the last decade and to evaluate predictors of long-term event-free survival.<br />Methods: Medical records were retrospectively analyzed of patients who underwent BMV between 2009 and 2021. The primary outcome was a composite endpoint of all-cause mortality, mitral valve replacement (MVR), and repeat BMV. Long-term event-free survival was estimated using Kaplan-Meier curves. Logistic regression was used to create a multivariate model to assess pre-procedural predictors of the primary outcome.<br />Results: A total of 96 patients underwent BMV during the study period. The primary outcome occurred in 36 patients during 12-year follow-up: one (1%) patient underwent re-BMV, 28 (29%) underwent MVR, and eight (8%) died. Overall, event-free survival was 62% at 12 years. On multivariate analysis, pre-procedural left atrial volume index (LAVI) > 80 mL/m2 had a significant independent influence on event-free survival, as did previous mitral valve procedure and systolic pulmonary arterial pressure above 50 mmHg.<br />Conclusions: Despite being a relatively low-volume center, excellent short and long-term results were demonstrated, with event-free survival rates consistent with previous studies from high-volume centers. LAVI independently predicted long-term event-free survival.

Details

Language :
English
ISSN :
1898-018X
Volume :
30
Issue :
5
Database :
MEDLINE
Journal :
Cardiology journal
Publication Type :
Academic Journal
Accession number :
36200547
Full Text :
https://doi.org/10.5603/CJ.a2022.0092