Aims: To assess the long-term outcome of mitral balloon valvotomy (MBV) and identify predictors of restenosis- and event-free survival. Methods and results: We report the immediate and long-term clinical and echocardiographic results in 493 patients, mean age 31 ± 11, who underwent successful MBV and were followed-up for 0.5-15 years (median 5 ± 3) with clinical and echocardiographic examination. After MBV, mitral valve area increased from 0.84 ± 0.2 to 1.83 ± 0.53 cm2 (P < 0.0001) as measured by catheter and from 0.92 ± 0.17 to 1.96 ± 0.29 cm2 as measured by two-dimensional echo. Restenosis occurred in 86/493 (17.4%) patients and it was less frequent in patients with low echo score. Actuarial freedom from restenosis at 5, 7, 10, and 13 years were 89 ± 1, 81 ± 2, 68 ± 3, and 51 ± 6%, respectively, and was significantly higher in patients with low echo score. Event-free survival (death, redo MBV, mitral valve replacement, New York Heart Association functional Class III or IV) at 5, 7, 10, and 13 years were 92 ± 1, 87 ± 2, 80 ± 3, and 74 ± 3%, respectively, and was significantly higher for patients with low echo score. Cox regression analysis identified mitral echocardiographic score (MES) >8 as predictors of restenosis (P = 0.0004) and MES and age as predictors of event-free survival (P = 0.0003 and 0.004, respectively). Conclusion: MBV has excellent long-term results for selected patients with mitral stenosis. The long-term outcome after this procedure can be predicted from baseline clinical and valvular characteristics. © The European Society of Cardiology 2005. All rights reserved.
