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Percutaneous mitral valvuloplasty in surgical high risk patients.

Abstract：

:Among 126 consecutive patients undergoing percutaneous mitral valvuloplasty, 34 were judged to be at high risk for surgery on the basis of age greater than 70 years (n = 13), New York Heart Association functional class IV (n = 11), ejection fraction less than or equal to 35% (n = 3), severe pulmonary hypertension (n = 7), need for associated coronary bypass (n = 4) or additional valve surgery (n = 20) or severe pulmonary disease (n = 3). Baseline features of the high risk group were substantially worse than those of the other patients: age (65 +/- 11 versus 49 +/- 12 years; p = 0.0001) and echocardiographic score (9.4 +/- 1.8 versus 8.2 +/- 1.5; p = 0.005) were higher, whereas cardiac output (2.9 +/- 0.9 versus 4.1 +/- 1.2 liters/min; p = 0.0001) and mitral valve area (0.9 +/- 0.4 versus 1.1 +/- 0.3 mm2; p = 0.002) were lower. Three high risk patients experienced technical failures and three others had major complications. Among the remaining 28 patients, 18 (65%) had a complete hemodynamic success, 4 (14%) an incomplete success and 6 (21%) hemodynamic failure. Stepwise logistic regression analysis retained echocardiographic score as the only factor independently predictive of success. The percent increase in mitral valve area also correlated with echocardiographic score (r = 0.51, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Lefèvre T,Bonan R,Serra A,Crépeau J,Dyrda I,Petitclerc R,Leclerc Y,Vanderperren O,Waters D

doi

10.1016/s0735-1097(10)80098-1

subject

Has Abstract

pub_date

1991-02-01 00:00:00

pages

348-54

issue

2

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(10)80098-1

journal_volume

17

pub_type

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