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Multicenter Study
. 2024 Aug 20;13(16):e031433.
doi: 10.1161/JAHA.123.031433. Epub 2024 Aug 9.

Impact of Procedural Success Definitions on Long-Term Outcomes in Patients With Rheumatic Mitral Stenosis Treated With Percutaneous Balloon Mitral Valvuloplasty: A Multicenter, Retrospective Cohort Study

Premanan Manoret  1 , Tasalak Thonghong  2 , Krissada Meemook  3 , Seththawut Kosallavat  3 , Suchart Aroonsiriwattana  4 , Thammarak Songsangjinda  1 , Saranyou Suwanugsorn  1 , Thanapon Nilmoje  1 , Sirichai Cheewatanakornkul  1 , Treechada Wisaratapong  1 , Sunti Limumpornpetch  1 , Watchara Lohawijarn  1 , Metus Thungthienthong  1   3 , Noppadol Chamnarnphol  1 , Mann Chandavimol  3 , Pannipa Suwannasom  2 , Woravut Jintapakorn  1   5 , Ply Chichareon  1   5
Affiliations
Multicenter Study

Impact of Procedural Success Definitions on Long-Term Outcomes in Patients With Rheumatic Mitral Stenosis Treated With Percutaneous Balloon Mitral Valvuloplasty: A Multicenter, Retrospective Cohort Study

Premanan Manoret et al. J Am Heart Assoc. .

Abstract

Background: It is uncertain which percutaneous balloon mitral valvuloplasty (PBMV) success definitions should be used because there are no studies comparing the effects of these definitions on subsequent outcomes. We evaluated the association between 3 success definitions and long-term clinical outcomes in patients with rheumatic mitral stenosis who underwent PBMV.

Methods and results: This multicenter retrospective study included patients with severe rheumatic mitral stenosis who underwent PBMV. Three definitions were used as follows: (A) post-PBMV mitral valve area (MVA) ≥1.5 cm2 or ≥50% increase in MVA with MR <3+; (B) post-PBMV MVA ≥1.5 cm2 and MR ≤2+; and (C) post-PBMV MVA ≥1.5 cm2 or ≥50% increase in MVA, with no more than 1-grade increment in MR. Multivariable Cox regression analyses were performed to evaluate the associations between PBMV success and the composite of all-cause mortality, mitral surgery, and repeat PBMV. Successful PBMV, according to definitions A, B, and C was associated with a lower risk of the composite outcomes (definition A-hazard ratio [HR], 0.55 [95% CI, 0.43-0.69], definition B-HR, 0.55 [95% CI, 0.43-0.69], definition C-HR, 0.55 [95% CI, 0.44-0.69]). Patients meeting all 3 success definitions had the lowest risk compared with those who did not meet any definition or met 1 or 2 definitions.

Conclusions: All 3 success definitions had a prognostic impact on outcomes. Patients who achieved post-PBMV MVA ≥1.5 cm2, irrespective of the percentage increase in MVA, and MR ≤grade 2, with no more than a 1-grade increment in MR, had the most favorable outcomes.

Keywords: PBMV; complications; long‐term outcome; percutaneous balloon mitral valvuloplasty; rheumatic mitral stenosis; success definitions.

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Figures

Figure 1
Figure 1. Flow of study population.
*Patients may have had >1 complication. †Patients may have had >1 missing information. MS indicates mitral stenosis; and PBMV, percutaneous balloon mitral valvuloplasty.
Figure 2
Figure 2. Kaplan–Meier curves of the composite outcomes according to success or unsuccess by definition A (A), definition B (B), or definition C (C).
HR indicates hazard ratio.
Figure 3
Figure 3. Kaplan–Meier curves of the composite outcomes according to the number of success definition met.
PBMV indicates percutaneous balloon mitral valvuloplasty.
Figure 4
Figure 4. The rate of composite outcomes according to the success definition met.
MR indicates mitral regurgitation; MVA, mitral valve area; and PBMV, percutaneous balloon mitral valvuloplasty.
See this image and copyright information in PMC

References

    1. Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, et al. 2020 ACC/AHA guideline for the Management of Patients with Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation. 2021;143:e72–e227. doi: 10.1161/CIR.0000000000000923 - DOI - PubMed
    1. Palacios IF. Percutaneous mitral balloon Valvuloplasty: worldwide trends. J Am Heart Assoc. 2019;8:e012898. doi: 10.1161/JAHA.119.012898 - DOI - PMC - PubMed
    1. Palacios IF. Percutaneous mitral balloon valvuloplasty—state of the art. Minim Invasive Surg. 2020;4:73. doi: 10.20517/2574-1225.2020.72 - DOI
    1. Badheka AO, Shah N, Ghatak A, Patel NJ, Chothani A, Mehta K, Singh V, Patel N, Grover P, Deshmukh A, et al. Balloon mitral valvuloplasty in the United States: a 13‐year perspective. Am J Med. 2014;127:1126‐e1. doi: 10.1016/j.amjmed.2014.05.015 - DOI - PubMed
    1. Meneguz‐Moreno RA, Costa JR Jr, Gomes NL, Braga SLN, Ramos AIO, Meneghelo Z, Maldonado M, Ferreira‐Neto AN, Franca JID, Siqueira D, et al. Very long term follow‐up after percutaneous balloon mitral valvuloplasty. JACC Cardiovasc Interv. 2018;11:1945–1952. doi: 10.1016/j.jcin.2018.05.039 - DOI - PubMed

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