Predictors of the Development of Significant Mitral Regurgitation Following Repeated Percutaneous Balloon Mitral Valvuloplasty in Middle-Aged and Elderly Patients

Background: We aimed to identify the predictor of developing significant mitral regurgitation (MR) after repeated percutaneous balloon mitral valvuloplasty (PBMV) via the Inoue Balloon Technique in middle-aged and elderly patients. Methods: This prospective study was performed on 40 patients presenting to the cardiology department with severe symptomatic mitral restenosis following previous PBMV via the Inoue Balloon Technique. Informed written consent was obtained from all the patients. MR was evaluated before and after PBMV and subsequently at short-term follow-up. Results: The study population was aged above 45 years. The 40 patients recruited were divided into 2 main groups: Group A comprised 28 patients who did not develop an increase in the grade of MR at follow-up and Group B consisted of 12 patients who developed at least a 1-grade increase in MR at follow-up. The results were compared before, after, and at short-term follow-up between the 2 study groups. The forward stepwise logistic regression analysis identified the presence of preprocedural Grade I MR as the most important independent predictor of the development of MR after PBMV (P = 0.01). No significant difference was observed between the study groups concerning symptomatic and hemodynamic improvements after PBMV. Conclusions: The presence of preprocedural Grade I MR may be the most independent predictor of a rise in the MR grade following repeated PBMV in middle-aged and elderly patients.