<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Percutaneous mitral balloon valvuloplasty is the main</spa...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Percutaneous mitral balloon valvuloplasty is the main</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases;however, mitral regurgitation (MR) remains the major procedure complication.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">This study was conducted to investigate</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">predictors of MR as a complication following</span><b></b><span style="font-family:Verdana;">percutaneous mitral valvuloplasty (PMV) using multitrack balloon technique.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Most patients (N = 109, </span><span style="font-family:;" "=""><span style="font-family:Verdana;">90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR (group B) after PMV. Those who developed severe MR had significantly higher weight, height, body mass index, and body surface area (P value < 0.001 for each). Also, there was a significant difference between both groups regarding pre-operative Wilkins score (8.7 ± 1.3 for severe MR versus 7.9 ± 1.2 for No/Mild MR, P = 0.046). Patients who developed severe MR had higher incidence of other valvular lesions such as mild aortic regurgitation (91.7% versus 36.7%, P < 0.001), higher mitral valve (MV) commissural calcification (50.0% versus 14.7%, P = 0.008), pre-operative MR (100.0% versus</span><a name="page2"></a><span style="font-family:Verdana;"> 35.8%, P < 0.001), higher prevalence of atrial fibrillation (100.0% versus 38.5%, P < 0.001). Regarding balloon sizing, it was significantly higher among patients who developed severe MR compared with those having mild or no MR (P = 0.001). Multivariate regression analysis identified MV balloon sizing (OR 3.877, CI 95% 1.131</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">13.289, P = 0.031) and MV commissural asymmetry of calcification (OR 67.48, CI 95% 5.759</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">790.72, P = 0.001) as significant predictors of outcomes of MV commissurotomy.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Mitral valve calcification, balloon sizing, and MV asymmetry are significant factors that can predict the development of MR after balloon valvuloplasty.</span>展开更多
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">Percutaneous mitral balloon valvuloplasty is the main</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases;however, mitral regurgitation (MR) remains the major procedure complication.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objectives: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">This study was conducted to investigate</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">predictors of MR as a complication following</span><b></b><span style="font-family:Verdana;">percutaneous mitral valvuloplasty (PMV) using multitrack balloon technique.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Most patients (N = 109, </span><span style="font-family:;" "=""><span style="font-family:Verdana;">90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR (group B) after PMV. Those who developed severe MR had significantly higher weight, height, body mass index, and body surface area (P value < 0.001 for each). Also, there was a significant difference between both groups regarding pre-operative Wilkins score (8.7 ± 1.3 for severe MR versus 7.9 ± 1.2 for No/Mild MR, P = 0.046). Patients who developed severe MR had higher incidence of other valvular lesions such as mild aortic regurgitation (91.7% versus 36.7%, P < 0.001), higher mitral valve (MV) commissural calcification (50.0% versus 14.7%, P = 0.008), pre-operative MR (100.0% versus</span><a name="page2"></a><span style="font-family:Verdana;"> 35.8%, P < 0.001), higher prevalence of atrial fibrillation (100.0% versus 38.5%, P < 0.001). Regarding balloon sizing, it was significantly higher among patients who developed severe MR compared with those having mild or no MR (P = 0.001). Multivariate regression analysis identified MV balloon sizing (OR 3.877, CI 95% 1.131</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">13.289, P = 0.031) and MV commissural asymmetry of calcification (OR 67.48, CI 95% 5.759</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">790.72, P = 0.001) as significant predictors of outcomes of MV commissurotomy.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Mitral valve calcification, balloon sizing, and MV asymmetry are significant factors that can predict the development of MR after balloon valvuloplasty.</span>
