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Comparison of Long-Term Outcome After Mitral Valve Replacement or Repeated Balloon Mitral Valvotomy in Patients With Restenosis After Previous Balloon Valvotomy

 Jin-Bae Kim  ;  Jong-Won Ha  ;  Sung-Soon Kim  ;  Seung-Yun Cho  ;  Namsik Chung  ;  Yangsoo Jang  ;  Donghoon Choi  ;  Young-Guk Ko  ;  Seok-Min Kang  ;  Won-Heum Shim  ;  Jung-Sun Kim 
 American Journal of Cardiology, Vol.99(11) : 1571-1574, 2007 
Journal Title
 American Journal of Cardiology 
Issue Date
Symptomatic mitral stenosis (MS) develops in 7% to 21% of patients after percutaneous mitral balloon valvotomy (PMV). Treatment options for these patients are surgical mitral valve replacement (MVR) or repeated PMV. However, no comparisons were made between these 2 procedures regarding long-term outcome. This retrospective study compares the long-term outcome of 888 patients with symptomatic MS after MVR or repeated PMV who underwent PMV from April 1988 to December 2003. Thirty-two patients subsequently underwent repeated PMV, and 59 patients underwent MVR for symptomatic MS. Mean follow-up was 85 +/- 43 months with a maximum follow-up of 15 years. Patients with MVR have more unfavorable clinical characteristics, including a higher incidence of atrial fibrillation and severe mitral regurgitation. Event-free survival was similar between the 2 groups up to 40 months after the procedure; 3-year event-free survival rates were 96.6% for MVR patients and 90.0% for repeated PMV patients (p = 0.215). However, after 40 months, the outcome was more favorable for MVR. Comparing MVR versus PMV, 6-year event-free survival rates were 93.0% versus 75.9% (p = 0.036), and 9-year event-free survival rates were 90.4% versus 36.0% (p <0.001). In conclusion, the long-term outcome of patients with symptomatic MS after previous PMV was more favorable after MVR than after repeated PMV. These data suggest that MVR may be the preferred mode of therapy in patients with unfavorable valve morphologic characteristics and no co-morbid disease.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강석민(Kang, Seok Min) ORCID logo https://orcid.org/0000-0001-9856-9227
고영국(Ko, Young Guk) ORCID logo https://orcid.org/0000-0001-7748-5788
김성순(Kim, Sung Soon)
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
김진배(Kim, Jin Bae)
심원흠(Shim, Won Heum)
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
정남식(Chung, Nam Sik)
조승연(Cho, Seung Yun)
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
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