Immediate and Long-Term Results of Percutaneous Mitral Valvuloplasty Using the Inoue Balloon

Background and Objectives：The objective of this study was to assess the short- and long-term clinical outcomes and valvular changes after percutaneous mitral valvuloplasty (PMV) in Sejong Hospital. Subjects and Methods： Four hundred sixty-seven patients received PMV using the Inoue Balloon at Sejong hospital from 1990 to 2002. Short and long-term results, restenosis-free survival rate and prognostic factors for each result were analyzed by Chi-square, Cox regression analysis, Life table method and Cox proportional hazard model. Results：After PMV, mitral valve area increased from 0.94±0.21 cm2 to 1.76±0.37 cm2 and the success rate (MVA>1.5 cm2 or incre-ased by at least 50 % without the development of moderate to severe mitral regurgitation) was 78.9%. Age (≤50 years, p=0.018), echo score (≤9, p=0.05) and pre-procedural mitral valve area (MVA, ≥1.1 cm2, p=0.001) were independent favorable prognostic factors for short-term result. As for the development of moderate to severe mitral regurgitation, pre-procedural MVA (≤1.0 cm2, p=0.031) and echo score (>9, p=0.043) were independent predictive factors. Median restenosis-free survival was 82.98 months and the restenosis-free survival rate was 70.9 % at 3 years post-PMV, 48.1 % at 6 years and 29.6 % at 10 years. The independent prognostic factor for restenosis-free survival rate was left atrial dimension (LAD≤60 mm, p=0.015). In addition, echo score (≤8, p=0.412), pre-procedural MVA (≥1.0 cm2, p=0.24) and ejection fraction (EF≥55%, p=0.146) had an effect o