Predictive role of SEC in mitral restenosis following successful percutaneous balloon mitral valvuloplasty (PBMV)

Aim: The aim of this study was to investigate the predictive role of spontaneous echo contrast (SEC) in mitral restenosis after percutaneous balloon mitral valvuloplasty (PBMV). Material and Methods: We retrospectively analyzed 341 consecutive patients who underwent PBMV at our hospital. Subjects who participated in the study were assigned to two groups: patients who had demonstrable SEC in the left atrial cavity and left atrial appendage and patients who did not have SEC in the left atrial cavity and left atrial appendage. For each group, the following variables were analyzed: demographic characteristics, past medical records, laboratory values, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) parameters. Results: Compared to patients without SEC, patients with SEC were older, had a higher incidence of diabetes mellitus (DM), ischemic stroke and AF (p<0.05). With respect to TTE and TEE measurements, patients with SEC had lower estimated pre-procedural left ventricular ejection fraction (LVEF), a smaller calculated mitral valve area (MVA), a larger left atrial (LA) dimension and higher estimated preprocedural Wilkins score (p<0.05). In addition, the incidence of mitral restenosis following PBMV was significantly higher in patients with SEC compared to patients without SEC ( p <0.05), and this difference was more apparent in patients with grade 3-4 SEC compared to those with grade 1-2 SEC (p<0.05) Discussion: Our data showed that there is a strong association between SEC formation in the left atrium and left atrial appendage and mitral restenosis following PBMV