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Ann Thorac Surg 2006;82:828-833
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Predictors of Surgery After Percutaneous Mitral Valvuloplasty

Adam D. Zimmet, MBBSa, Aubrey A. Almeida, FRACSa,c, Richard W. Harper, MBBSb,d, Joseph J. Smolich, MBBS, PhDb,d, Jacob Goldstein, FRACSa,c, Gilbert C. Shardey, FRACSa,c, Julian A. Smith, FRACSa,*

a Cardiothoracic Surgery, Monash Medical Center, Clayton, Victoria, Australia
b Cardiology Units, Monash Medical Center, Clayton, Victoria, Australia
c Department of Surgery, Monash University, Clayton, Victoria, Australia
d Center for Heart and Chest Research, Monash University, Clayton, Victoria, Australia

Accepted for publication March 29, 2006.

* Address correspondence to Prof Smith, Department of Surgery, Level 5, E Block, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria 3168, Australia (Email: julian.smith{at}med.monash.edu.au).

BACKGROUND: Percutaneous mitral valvuloplasty (PMV) is a minimally invasive treatment option for selected patients with mitral stenosis (MS). In general, the procedure is well-tolerated with a high success rate. However, relatively little is known about the predictors of surgical intervention after PMV.

METHODS: A retrospective analysis was performed on 243 patients undergoing PMV at a single institution over a 14 year period.

RESULTS: Fifty (21%) of 243 patients, comprising 44 women and 6 men and aged 55 ± 14 years, underwent cardiac surgery at a median interval of 6 months (range, 0 to 130) after PMV. Nine (18%) underwent a procedure within 15 days, and 41 (82%) had a procedure more than 15 days after the valvuloplasty. After PMV, surgery-free survival was 85% at 1 year, 83% at 2 years, 81% at 3 years, 80% at 4 years, and 80% at 5 years.

CONCLUSIONS: The need for surgery after PMV is not uncommon. Independent predictors of surgery after PMV included severity of mitral regurgitation (p < 0.003) and a higher echo score (p < 0.039).




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