TY - JOUR
T1 - Percutaneous balloon dilatation of the mitral valve
T2 - An analysis of echocardiographic variables related to outcome and the mechanism of dilatation
AU - Wilkins, Gerard T.
AU - Weyman, Arthur E.
AU - Abascal, Vivian M.
AU - Block, Peter C.
AU - Palacios, Igor F.
PY - 1988
Y1 - 1988
N2 - Twenty two patients (four men, 18 women, mean age 56 years, range 21 to 88 years) with a history ofrheumatic mitral stenosis were studied by cross sectional echocardiography before and after balloon dilatation of the mitral valve. The appearance of the mitral valve on the predilatation echocardiogram was scored for leaflet mobility, leaflet thickening, subvalvar thickening, and calcification. Mitral valve area, left atrial volume, transmitral pressure difference, pulmonary artery pressure, cardiac output, cardiac rhythm, New York Heart Association functional class, age, and sex were also studied. Because there was some increase in valve area in almost all patients the results were classified as optimal or suboptimal (final valve area <1.0 cm2 final left atrial pressure > 10 mm Hg, or final valve area < 25% greater than the initial area). The best multiple logistic regression fit was found with the total echocardiographic score alone. Ahigh score (advanced leaflet deformity) was associated with a suboptimal outcome while a low score (a mobile valve with limited thickening) was associated with an optimal outcome. No other haemodynamic or clinical variables emerged as predictors of outcome in this analysis. Examination of pre-dilatation and post-dilatation echocardiograms showed that balloon dilatation reliably resulted in cleavage of the commissural plane and thus an increase in valve area.
AB - Twenty two patients (four men, 18 women, mean age 56 years, range 21 to 88 years) with a history ofrheumatic mitral stenosis were studied by cross sectional echocardiography before and after balloon dilatation of the mitral valve. The appearance of the mitral valve on the predilatation echocardiogram was scored for leaflet mobility, leaflet thickening, subvalvar thickening, and calcification. Mitral valve area, left atrial volume, transmitral pressure difference, pulmonary artery pressure, cardiac output, cardiac rhythm, New York Heart Association functional class, age, and sex were also studied. Because there was some increase in valve area in almost all patients the results were classified as optimal or suboptimal (final valve area <1.0 cm2 final left atrial pressure > 10 mm Hg, or final valve area < 25% greater than the initial area). The best multiple logistic regression fit was found with the total echocardiographic score alone. Ahigh score (advanced leaflet deformity) was associated with a suboptimal outcome while a low score (a mobile valve with limited thickening) was associated with an optimal outcome. No other haemodynamic or clinical variables emerged as predictors of outcome in this analysis. Examination of pre-dilatation and post-dilatation echocardiograms showed that balloon dilatation reliably resulted in cleavage of the commissural plane and thus an increase in valve area.
UR - http://www.scopus.com/inward/record.url?scp=0023710752&partnerID=8YFLogxK
U2 - 10.1136/hrt.60.4.299
DO - 10.1136/hrt.60.4.299
M3 - Article
C2 - 3190958
AN - SCOPUS:0023710752
SN - 1355-6037
VL - 60
SP - 299
EP - 308
JO - Heart
JF - Heart
IS - 4
ER -