Impact of Procedural Success Definitions on Long-Term Outcomes in Patients With Rheumatic Mitral Stenosis Treated With Percutaneous Balloon Mitral Valvuloplasty: A Multicenter, Retrospective Cohort Study
Issued Date
2024-08-20
Resource Type
eISSN
20479980
Scopus ID
2-s2.0-85201986740
Pubmed ID
39119978
Journal Title
Journal of the American Heart Association
Volume
13
Issue
16
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the American Heart Association Vol.13 No.16 (2024)
Suggested Citation
Manoret P., Thonghong T., Meemook K., Kosallavat S., Aroonsiriwattana S., Songsangjinda T., Suwanugsorn S., Nilmoje T., Cheewatanakornkul S., Wisaratapong T., Limumpornpetch S., Lohawijarn W., Thungthienthong M., Chamnarnphol N., Chandavimol M., Suwannasom P., Jintapakorn W., Chichareon P. Impact of Procedural Success Definitions on Long-Term Outcomes in Patients With Rheumatic Mitral Stenosis Treated With Percutaneous Balloon Mitral Valvuloplasty: A Multicenter, Retrospective Cohort Study. Journal of the American Heart Association Vol.13 No.16 (2024). doi:10.1161/JAHA.123.031433 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101154
Title
Impact of Procedural Success Definitions on Long-Term Outcomes in Patients With Rheumatic Mitral Stenosis Treated With Percutaneous Balloon Mitral Valvuloplasty: A Multicenter, Retrospective Cohort Study
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND: It is uncertain which percutaneous balloon mitral valvuloplasty (PBMV) success definitions should be used because there are no studies comparing the effects of these definitions on subsequent outcomes. We evaluated the association between 3 success definitions and long-term clinical outcomes in patients with rheumatic mitral stenosis who underwent PBMV. METHODS AND RESULTS: This multicenter retrospective study included patients with severe rheumatic mitral stenosis who underwent PBMV. Three definitions were used as follows: (A) post-PBMV mitral valve area (MVA) ≥1.5 cm2 or ≥50% increase in MVA with MR <3+; (B) post-PBMV MVA ≥1.5 cm2 and MR ≤2+; and (C) post-PBMV MVA ≥1.5 cm2 or ≥50% increase in MVA, with no more than 1-grade increment in MR. Multivariable Cox regression analyses were performed to evaluate the associations between PBMV success and the composite of all-cause mortality, mitral surgery, and repeat PBMV. Successful PBMV, according to definitions A, B, and C was associated with a lower risk of the composite outcomes (definition A—hazard ratio [HR], 0.55 [95% CI, 0.43–0.69], definition B—HR, 0.55 [95% CI, 0.43–0.69], definition C—HR, 0.55 [95% CI, 0.44–0.69]). Patients meeting all 3 success definitions had the lowest risk compared with those who did not meet any definition or met 1 or 2 definitions. CONCLUSIONS: All 3 success definitions had a prognostic impact on outcomes. Patients who achieved post-PBMV MVA ≥1.5 cm2, irrespective of the percentage increase in MVA, and MR ≤grade 2, with no more than a 1-grade increment in MR, had the most favorable outcomes.