https://doi.org/10.4081/monaldi.2024.2941
20-year follow-up of rheumatic mitral stenosis patients after percutaneous mitral commissurotomy: invasive transmitral gradient differential as a predictor of events
Submitted: February 7, 2024
Accepted: February 23, 2024
Published: March 11, 2024
Accepted: February 23, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Percutaneous mitral valve commissurotomy (PMC) is a viable alternative to mitral valve (MV) surgery in the treatment of patients with rheumatic mitral stenosis (RMS). In this single-center retrospective study of consecutive patients with RMS submitted to PMC from 1991 to 2008, we analyzed clinical, echocardiographic, and hemodynamic data and events during follow-up (FUP) until December 2021. Major adverse cardiovascular events (MACE) were a combined endpoint of all-cause death, cardiovascular hospitalization, and MV re-intervention. A total of 124 patients were enrolled: 108 (87.1%) were female, with a mean age at PMC of 46 [standard deviation (SD) 11] years. PMC was successful in 91.1%, with a mean reduction in invasive transmitral pressure gradient (TMPG) of 8 (SD 7) mmHg at PMC time. During the mean FUP of 20 (SD 6) years, 51 (41.1%) patients had MV re-intervention (86.3% surgery and 13.7% redo-PMC), 37 (29.8%) were hospitalized, and 30 (24.2%) died. Approximately 75% of patients remained MACE-free after 10 years, and this percentage decreased to around 40% after 20 years; at this time mark, about 8 in 10 patients were alive. A reduction of <5 mmHg in TMPG at PMC time was associated with a 2.7-fold greater rate of MACE compared to a reduction of ≥5 mmHg, independent of MV regurgitation after PMC and moderate disease of other valves (adjusted hazard ratio 2,7; 95% confidence interval 1.395-5.298, p=0.003). In this cohort with favorable long-term results after PMC, a reduction of <5 mmHg in TMPG at PMC time was associated with MACE during FUP. More studies are needed to validate this independent predictor.
Dougherty S, Okello E, Mwangi J, Kumar RK. Rheumatic heart disease: JACC focus seminar 2/4. J Am Coll Cardiol 2023;81:81-94.
DOI: https://doi.org/10.1016/j.jacc.2022.09.050
Kumar RK, Antunes MJ, Beaton A, et al. Contemporary diagnosis and management of rheumatic heart disease: implications for closing the gap: a scientific statement from the American Heart Association. Circulation 2020;142:e337-57.
Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 2022;43:561-632.
DOI: https://doi.org/10.1093/ejcts/ezac209
Singh AD, Mian A, Devasenapathy N, et al. Percutaneous mitral commissurotomy versus surgical commissurotomy for rheumatic mitral stenosis: a systematic review and meta-analysis of randomised controlled trials. Heart 2020;106:1094-101.
DOI: https://doi.org/10.1136/heartjnl-2019-315906
Inoue K, Owaki T, Nakamura T, et al. Clinical application of transvenous mitral commissurotomy by a new balloon catheter. J Thorac Cardiovasc Surg 1984;87:394-402.
DOI: https://doi.org/10.1016/S0022-5223(19)37390-8
Feldman T, Herrmann HC, Inoue K. Technique of percutaneous transvenous mitral commissurotomy using the Inoue balloon catheter. Cathet Cardiovasc Diagn 1994;2:26-34.
Mehran R, Rao SV, Bhatt DL, et al. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium. Circulation 2011;123:2736-47.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.110.009449
Chmielak Z, Kruk M, Demkow M, et al. Long-term follow-up of patients with percutaneous mitral commissurotomy. Kardiol Pol 2008;66:525-30.
Khan I, Shah B, Habeel Dar M, et al. Clinical and echocardiographic follow-up after successful percutaneous transvenous mitral commissurotomy. Cureus 2017;9:1726.
DOI: https://doi.org/10.7759/cureus.1726
Ahmed A, Mohammed N, Rahhal A, et al. Percutaneous transvenous balloon mitral commissurotomy: a single-center experience. Heart Views 2022;23:127-32.
DOI: https://doi.org/10.4103/heartviews.heartviews_78_22
Fawzy ME. Long-term results up to 19 years of mitral balloon valvuloplasty. Asian Cardiovasc Thorac Ann 2009;17:627-33.
DOI: https://doi.org/10.1177/0218492309349258
Bouleti C, Iung B, Himbert D, et al. Reinterventions after percutaneous mitral commissurotomy during long-term follow-up, up to 20 years: the role of repeat percutaneous mitral commissurotomy. Eur Heart J 2013;34:1923-30.
DOI: https://doi.org/10.1093/eurheartj/eht097
Kubota N, Ozaki K, Hoyano M, et al. Long-term prognosis of patients who underwent percutaneous transvenous mitral commissurotomy for mitral stenosis. Int Heart J 2020;61:1183-7.
DOI: https://doi.org/10.1536/ihj.20-082
Braiteh N, Zgheib A, Kashou AH, et al. Immediate and long-term results of percutaneous mitral commissurotomy: up to 15 years. Am J Cardiovasc Dis 2019;15:34-41.
Macrotrends. Portugal Life Expectancy 1950-2024. Available from: https://www.macrotrends.net/countries/PRT/portugal/life-expectancy. Accessed on: 21/02/2024.
Wunderlich NC, Dalvi B, Ho SY, et al. Rheumatic mitral valve stenosis: diagnosis and treatment options. Curr Cardiol Rep 2019;21:14.
DOI: https://doi.org/10.1007/s11886-019-1099-7
Pavlides GS, Nahhas GT, London J, et al. Predictors of long-term event-free survival after percutaneous balloon mitral valvuloplasty. Am J Cardiol 1997;79:1370-4.
DOI: https://doi.org/10.1016/S0002-9149(97)00142-2
Meneguz-Moreno RA, Ferreira-Neto AN, Gomes NL, et al. Independent clinical and echocardiographic predictors of restenosis after percutaneous mitral balloon commissurotomy in a large, consecutive cohort followed for 24 Years. J Invasive Cardiol 2023;35:E113-21.
Bouleti C, Iung C, Laouenan C, et al. Late results of percutaneous mitral commissurotomy up to 20 years: development and validation of a risk score predicting late functional results from a series of 912 patients. Circulation 2012;125:2119-27.
DOI: https://doi.org/10.1161/CIRCULATIONAHA.111.055905
Ethics Approval
The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki. Observational studies are not mandatory to be proposed to the local ethical committee.How to Cite
Amador, Ana Filipa, Catarina Costa, Ricardo Pinto, Miguel Carvalho, Tânia Proença, João Calvão, Sandra Amorim, Mariana Paiva, João Carlos Silva, and Rui Rodrigues. 2024. “20-Year Follow-up of Rheumatic Mitral Stenosis Patients After Percutaneous Mitral Commissurotomy: Invasive Transmitral Gradient Differential As a Predictor of Events”. Monaldi Archives for Chest Disease, March. https://doi.org/10.4081/monaldi.2024.2941.
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