Percutaneous balloon mitral valvuloplasty in patients with mitral restenosis after previous surgical commissurotomy: A matched comparative study

Background Although the efficacy of percutaneous balloon mitralvalvuloplasty in patients with unoperated mitral stenosis hasbeen well documented, there exists less clear-cut data on itseffectiveness in patients with mitral restenosis after previoussurgical commissurotomy. Accordingly, the purpose of this studywas to evaluate our immediate and midterm results of balloonmitral valvuloplasty in this subset of patients with previousmitral surgery. Methods Between October 1991 and August 1995, 29 consecutivepatients with mitral restenosis after prior surgical commissurotomy(group 1) underwent Inoue balloon mitral valvuloplasty. Theywere matched on a patient-to-patient basis with regards to baselinemitral echocardiographic score, mitral valve area, seventy ofangiographic mitral regurgitation and follow-up duration with29 other patients with unoperated mitral stenosis (group 2)who underwent balloon mitral valvuloplasty during the same studyperiod. Results Balloon mitral valvuloplasty yielded identical improvementsin transmitral gradient and mitral valve area (from 0.8 to 1.6cm² determined echocardiographically, and similar changes inthe severity of mitral regurgitation in both groups of patients.All procedures were successfully completed without major cardiaccomplications. Follow-up echocardiographic assessment in 73%of patients revealed equal mitral valve area (1.6 cm²) and arestenosis rate of 17%, with no difference in the restenosisrate between the two groups. Conclusion Balloon mitral valvuloplasty in selected patientswith mitral restenosis after past surgical commissurotomy canbe performed safely and with similar immediate and midterm efficacyas in patients with de novo mitral stenosis.