Valvular heart diseaseComparison of Long-Term Outcome After Mitral Valve Replacement or Repeated Balloon Mitral Valvotomy in Patients With Restenosis After Previous Balloon Valvotomy
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Patients
Eight hundred eighty-eight patients underwent PMV in our institution from April 1988 to December 2003. Of these, we identified 32 patients who underwent repeated PMV for symptomatic restenosis (repeated-PMV group) and 59 patients who underwent MVR (MVR group) during the same period. Criteria for choosing MVR or repeated PMV in patients with restenosis were at the discretion of the attending physician. Clinical outcome (such as repeated procedure, stroke, readmission for heart failure, and
Pre- and postprocedural characteristics of patients
Baseline characteristics of both groups of patients are listed in Table 1. Repeated PMV was performed at 72.7 ± 34.3 months after initial PMV and MVR at 57.6 ± 35.2 months after initial PMV. Patients in the repeated-PMV group were generally younger than those in the MVR group (42 ± 11 vs 50 ± 10 years, p = 0.001) and had a lower incidence of atrial fibrillation (29% vs 55%, p = 0.02). Pre- and postprocedural echocardiographic parameters are listed in Table 2. There was a significant increase in
Discussion
The present study compares MVR with repeated PMV in patients with mitral restenosis after previous PMV for whom long-term follow-up >10 years could be analyzed. Data show that MVR is associated with better long-term event-free survival and remains superior to repeated PMV for up to 15 years after surgery. These data suggest that MVR may be the preferred mode of therapy for patients who are expected to benefit during a long period. The strength of this study is the availability of data for
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