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Revista mexicana de cardiología
Print version ISSN 0188-2198
Abstract
ALVARADO-PEREZ, Geovani Sabino and PALACIOS-RODRIGUEZ, Juan Manuel. Percutaneous mitral balloon valvuloplasty: clinical and echocardiographic factors associated with success in a Tertiary-Care Hospital in Mexico. Rev. Mex. Cardiol [online]. 2018, vol.29, n.4, pp.159-167. Epub Apr 25, 2022. ISSN 0188-2198.
Introduction:
Prevalence of mitral stenosis of rheumatic etiology has diminished. However, in Mexico there are some regions where still represents a health issue in productive population. Percutaneous valvuloplasty has become the treatment of choice in those with favorable anatomy. When successful immediate results are obtained, adequate long-term results are predicted.
Objective:
To determine the clinical and echocardiographic factors associated with the immediate success of percutaneous mitral valvuloplasty.
Material and methods:
A comparative and retrospective cross-sectional, observational study. Clinical records of patients treated with percutaneous valvuloplasty between 2000-2016 were reviewed. We studied clinical, echocardiographic, and procedural factors associated with immediate success. Descriptive and inferential statistics were used with SPSS v2.4 package.
Results:
A total of 363 patients. Female gender 287 (79.1%), age 50.8 ± 10.9 years. Functional class II 218 (60.1%). Atrial fibrillation 201 (55.4%). Previous procedure 78 (21.5%). Wilkins score 8-10: 228 (62.8%). Previous moderate mitral insufficiency 20 (5.5%). Inoue Balloon used in 343 (94.5%). We achieved success in 309 (85.1%), 26 had complications (7.16%), one death. We observed an increased number of complications in patients with pulmonary hypertension (> 60 mmHg) (p = 0.01), transvalvular gradient (mean > 10 mmHg) (p = 0.049), previous moderate mitral regurgitation (p = 0.001), and procedures with double-balloon (p = 0.001). We identified as unfavorable predictors of the procedure with statistical significance: Wilkins score 8-10 points (OR 2.6, 95% CI, 1.3-5.2) and previous moderate mitral regurgitation (OR 3.3, 95% CI, 1.28-8.93).
Conclusion:
Similar results were obtained with previous studies (success, complications and mortality). Only the Wilkins score greater than 8 points and the previous moderate mitral regurgitation were unfavorable predictors for the success of the procedure.
Keywords : Mitral valvuloplasty; rheumatic mitral stenosis; Inoue balloon.
