Background and aim of the study: Long-term echocardiographic follow up studies of mitral balloon valvuloplasty (MBV) are scarce. The study aim was to assess the long-term results (up to 17 years) of MBV and to identify predictors of restenosis and event-free survival. Methods: The immediate and long-term clinical and echocardiographic results for 520 consecutive patients (mean age 31 ± 11 years) who underwent successful MBV for severe mitral stenosis (MS) and were followed up for a mean of 7.3 ± 4.35 years (range: 1 to 17 years) after MBV, were reported. Results: Immediately after MBV, the mitral valve area (MVA) was increased from 0.92 ± 0.17 to 1.96 ± 0.29 cm2 (p <0.0001). Restenosis occurred in 133 patients (25.6%), and was less frequent (16.7%) in patients with a low mitral echo score (MES ≤8). Actuarial freedom from restenosis at 10, 15, and 17 years was 73 ± 2%, 43 ± 4%, and 23 ± 6%, respectively, and was significantly higher in patients with MES ≤8 (84 ± 2%, 52 ± 6%, and 36 ± 9%, respectively; p <0.001). Event-free survival (death, redo MBV, mitral valve replacement, NYHA class III or IV) at 10, 15, and 17 years was 82 ± 2%, 45 ± 5%, and 31 ± 6% respectively, and was significantly higher for patients with MES ≤8 (90 ± 2%, 60 ± 5%, and 51 ± 8%, respectively; p <0.001). Cox regression analysis identified MES >8 (p <0.0001) and post-procedure MVA (p = 0.044) as predictors of restenosis, and MES ≤8 (p <0.0001), age (p <0.0001), and post-procedure MVA (p = 0.016) as predictors of event-free survival. Conclusion: MBV provides excellent long-term results for selected patients with MS. The long-term outcome of this procedure can be predicted from the baseline clinical and echocardiographic characteristics of the mitral valve. © Copyright by ICR Publishers 2007.
