Head-to-head comparison between redo percutaneous mitral valvuloplasty for mitral restenosis and percutaneous mitral valvuloplasty for de novo mitral stenosis

摘要

Aims: In a retrospective study design, we explored the immediate results of redo percutaneous mitral valvuloplasty in comparison with initial percutaneous mitral valvuloplasty. Methods and Results: We included 30 consecutive patients with de novo mitral stenosis (group A) and 40 consecutive patients with mitral restenosis after successful initial percutaneous mitral valvuloplasty (group B). Echocardiographic assessment of the mitral valve was performed in all patients by trans-thoracic echocardiography, and trans-esophageal echocardiography excluded left atrial thrombosis. percutaneous mitral valvuloplasty was performed by the antegrade trans-septal approach using either the standard Inoue technique or the multi-track technique. Patient assessment by trans-thoracic echocardiography was repeated 48 hours following the procedure. Procedural success was defined as a 50% or more increase of mitral valve area mitral valve area with a final mitral valve area ≥1.5 cm2, without major complications. Procedural success was achieved in 28 (93.3%) patients in group A, and in 37 (92.5%) patients in group B (p>0.05). The two groups were similar concerning the final mitral valve area, gain of mitral valve area, mean pressure gradient across the mitral valve and complication rate (p>0.05 for all). The final mitral valve area correlated negatively with the initial mitral valve score in both group A and B. Conclusion: Redo percutaneous mitral valvuloplasty for mitral restenosis achieves comparable immediate results to initial percutaneous mitral valvuloplasty.