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Predictors of Long-Term Outcomes of Percutaneous Mitral Valvuloplasty in Patients with Rheumatic Mitral Stenosis.

Authors
 Darae Kim  ;  Hyemoon Chung  ;  Jong-Ho Nam  ;  Dong Hyuk Park  ;  Chi Young Shim  ;  Jung-Sun Kim  ;  Hyuk-Jae Chang  ;  Geu-Ru Hong  ;  Jong-Won Ha 
Citation
 Yonsei Medical Journal, Vol.59(2) : 273-278, 2018 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2018
MeSH
Adult ; Catheterization* ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Mitral Valve Stenosis/diagnostic imaging ; Mitral Valve Stenosis/surgery* ; Multivariate Analysis ; Proportional Hazards Models ; Republic of Korea ; Time Factors ; Treatment Outcome
Keywords
Mitral stenosis ; outcome ; percutaneous mitral balloon valvuloplasty
Abstract
PURPOSE: We determined factors associated with long-term outcomes of patients who underwent successful percutaneous mitral balloon valvuloplasty (PMV). MATERIALS AND METHODS: Between August 1980 and May 2013, 1187 patients underwent PMV at Severance Hospital, Seoul, Korea. A total of 742 patients who underwent regular clinic visits for more than 10 years were retrospectively analyzed. The endpoints consisted of repeated PMV, mitral valve (MV) surgery, and cardiovascular-related death. RESULTS: The optimal result, defined as a post-PMV mitral valve area (MVA) >1.5 cm² and mitral regurgitation ≤Grade II, was obtained in 631 (85%) patients. Over a mean follow up duration of 214±50 months, 54 (7.3%) patients underwent repeat PMV, 4 (0.5%) underwent trido-PMV, and 248 (33.4%) underwent MV surgery. A total of 33 patients (4.4%) had stroke, and 35 (4.7%) patients died from cardiovascular-related reasons. In a multivariate analysis, echocardiographic score [p=0.003, hazard ratio=1.56, 95% confidence interval (CI): 1.01-2.41] and post-MVA cut-off (p<0.001, relative risk=0.39, 95% CI: 0.37-0.69) were the only significant predictors of long-term clinical outcomes after adjusting for confounding variables. A post-MVA cut-off value of 1.76 cm² showed satisfactory predictive power for poor long-term clinical outcomes. CONCLUSION: In this long-term follow up study (up to 20 years), an echocardiographic score >8 and post-MVA ≤1.76 cm² were independent predictors of poor long-term clinical outcomes after PMV, including MV reintervention, stroke, and cardiovascular-related death
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DOI
10.3349/ymj.2018.59.2.273
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김다래(Kim, Da Rae)
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
남종호(Nam, Jong-Ho)
박동혁(Park, Dong Hyuk)
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162049
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